Buttock necrosis following uterine artery embolization: A case report

INTRODUCTION AND IMPORTANCE: Fibroid is a very common benign tumor of the uterus for which uterine artery embolization is one of the treatment modalities of choice. Uterine artery embolization (UAE) is a minimally invasive procedure used in the management of fibroids, nowadays mostly performed by interventional radiologists. A rare complication of the procedure is buttock necrosis which has been observed in this case. If not identified at an early stage, it may result in extensive damage to a large surface area of the skin hence this case report is of clinical relevance as it is essential to be aware of the complications of UAE and be cautious. CASE PRESENTATION: Our report is regarding a 37-year-old female who presented to the emergency department with a gradually increasing excruciatingly painful lesion on the left buttock 12 days after undergoing a uterine artery embolization. Examination revealed a necrotic lesion involving 40 % surface area of the left buttock. CLINICAL DISCUSSION: There are a few other such cases reported in literature. All these cases, including ours, prove that buttock necrosis is an established complication which is highly possible following uterine artery embolization. This complication is likely due to reflux of embolic material into gluteal artery. CONCLUSION: This case warranted extensive debridement and plastic surgery referral for skin grafting. Although a rare scenario, being a dangerous and distressful one for patients, ability to recognize this complication at an early stage will aid in the management and mental well-being of the patient.