Post injection gluteal haematoma

Case contributed by Dr Maulik S Patel

Presentation

Gluteal injection - 15 days back. C/o large local swelling , pain in gluteal region. USG to rule out abscess formation.

Patient Data

Age: 25 yrs
Gender: Male
Modality: Ultrasound

A hypoechoic well-defined lesion is noted involving subcutaneous fat and muscles.  Only a small area of the lesion shows 'whirling' echoes.

The lesion is avascular. No significant perilesional hypervascularity.

Case Discussion

By knee jerk reaction due to history of post injection gluteal swelling - pain, it was reported to surgeon as an " odd " looking abscess. Next day surgeon called to say it was an haematoma.

Differentiating features in this case:

- It is well-defined lesion. Abscess should be illdefined.

- No perilesional echogenic fat seen in this. In Abscess there is central necrosis with perilesional shaggy wall which is surrounded by inflammed fat

- Mobile - whirling echoes are noted only a small part of the lesion. Abscess caviry shows whirling echoes in entire area.

- Wall / perilesional Hypervascularity is missing in this lesion.  Abscess should have both.

There was no history of known medical disease / patient was not takening any oral anticoagulant.

Post operative, bleeding was more than usual.

WBC counts were not measureable by cell counter.

Patient may be having a kind of haematological disorder and is under work up.

Follow up : diagnosis - chronic myeloid leukaemia.

 

PlayAdd to Share

Case Information

rID: 26443
Case created: 22nd Dec 2013
Last edited: 18th Dec 2015
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.