{
    "abstract": "Intramuscular injections are routine outpatient procedure performed at healthcare institutions worldwide. In the current literature, there have been very few reports of gluteal superior artery injuries due to incorrect injection techniques. However, no one has ever reported a healthy middle-aged man with systemic inflammatory response syndrome with possible injection-related bleeding from the gluteus superior artery, followed by a hematoma, and then a deep abscess after 3 weeks of not receiving treatment.\nA 40-year-old man presented with pain in his buttock, a fever of 40\u00b0, and a lump after a dorso-gluteal injection. (November, 2022) The patient was diagnosed with systemic inflammatory response syndrome due to a deep abscess related to a hematoma caused by a possible superior gluteal artery branch injury.\nHe was admitted to our institution with a lump, pain in his buttock, and a fever of 40\u00b0 after a dorso-gluteal injection. The patient had diffuse swelling and tenderness in the upper-posterior aspect of the gluteal region. Systemic examination revealed yellow sclera and icteric skin appearance. Blood tests showed low hemoglobin levels and increased pre-sepsis parameters (procalcitonin and indirect bilirubin). Pelvic MRI and ultrasonography revealed a gluteal abscess.\nThe patient was transferred to the operating theater, where a curved incision was made behind the trochanter. The gluteus maximus was bluntly dissected, and abscess fluid was drained from the muscle. Continuous bleeding was detected, suggesting iatrogenic superior gluteal artery branch injury at the time of the injection.\nAfter drainage and antibiotic treatment, the patient's parameters normalized within 5 days, and the patient was discharged. The patient's weekly follow-up examinations were normal, and he was able to walk without a limp. A postoperative visit to the outpatient clinic 2 months after the operation and a telephone call 17 months later showed that the patient was completely healthy and able to work.\nThe dorso-gluteal technique has potential risks, including possible injury to the sciatic nerve and superior gluteal artery and irritation of the subcutaneous adipose tissue. This article aims to highlight the potential risks of a particular technique and advocate the use of the ventrogluteal technique instead of the traditional dorso-gluteal technique.",
    "authors": [
        {
            "affiliation": "Department of Orthopedics and Traumatology, Baskent University, Alanya Research and Practice Hospital, Alanya/Antalya, Turkey.",
            "firstname": "Kemal",
            "initials": "K",
            "lastname": "Gokkus"
        },
        {
            "affiliation": "Department of Orthopedics and Traumatology, Baskent University, Alanya Research and Practice Hospital, Alanya/Antalya, Turkey.",
            "firstname": "Baris",
            "initials": "B",
            "lastname": "Sargin"
        },
        {
            "affiliation": "Baskent University Medical Faculty, Yukari Bah\u00e7elievler, \u00c7ankaya/Ankara, Turkey.",
            "firstname": "Bahtiyar",
            "initials": "B",
            "lastname": "Haberal"
        },
        {
            "affiliation": "Department of Orthopedics and Traumatology, Baskent University, Alanya Research and Practice Hospital, Alanya/Antalya, Turkey.",
            "firstname": "Mehmet Sukru",
            "initials": "MS",
            "lastname": "Sahin"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2024 the Author(s). Published by Wolters Kluwer Health, Inc.",
    "doi": "10.1097/MD.0000000000038930",
    "journal": "Medicine",
    "keywords": [],
    "methods": null,
    "publication_date": "2024-07-12",
    "pubmed_id": "38996111\n19918523\n7676237\n1875445\n25506847\n0\n24349403\n6133092\n15038176\n2041559\n13927909",
    "results": null,
    "title": "Injection, hematoma, abscess, systemic inflammatory response syndrome, stairway to hell: Case report.",
    "xml": "<Element 'PubmedArticle' at 0x788503431c10>"
}