Variations in the vasculature of the gluteal region: A case report and clinical implications

Abstract

PurposeTo report and describe multiple rare variations of the gluteal vasculature that were discovered during dissection. MethodsDuring a routine dissection of a cadaver in the gluteal region, the gluteus maximus muscle was reflected bilaterally and variations in the gluteal vasculature were discovered. In the pelvic cavity, the branches of the internal iliac arteries were exposed to reveal variations in the origins of these arteries. ResultsOn the left side of the gluteal region, the superficial branch of the superior gluteal artery was large and descended inferiorly across the piriformis muscle. The inferior gluteal artery was unusually small and with few branches. The internal pudendal artery gave off several branches with one of these branches contributing to the cruciate anastomosis. On the right side, an enlarged superficial branch of the superior gluteal artery descended over the piriformis muscle into the inferior half of the gluteal region and the inferior gluteal artery was completely absent. ConclusionsGluteal flaps used in the reconstruction of trunk wounds and pressure sores utilize the knowledge that both the superior and inferior gluteal arteries supply the local musculature of this region. In cases where a gluteal artery may be absent, like in the current study, lifting a flap based on one artery may lead to necrosis of adjacent musculature due to the loss of its blood supply. Knowledge of these types of anomalies may prompt surgeons to proceed with more caution during surgical interventions in the gluteal region.