CC BY-NC 4.0 · Arch Plast Surg 2018; 45(06): 588-592
DOI: 10.5999/aps.2017.01550
Case Report

Eruption of a venous malformation through an iliac bone harvesting site after trauma

Tatsuki Kono
Department of Plastic and Reconstructive Surgery, Showa University School of Medicine, Tokyo, Japan
,
Atsuomi Saiga
Department of Plastic and Reconstructive Surgery, St. Mary’s Hospital, Kurume, Japan
,
Keiichi Tamagawa
Department of Plastic and Reconstructive Surgery, St. Mary’s Hospital, Kurume, Japan
,
Kensuke Katsuki
Department of Plastic and Reconstructive Surgery, St. Mary’s Hospital, Kurume, Japan
,
Misako Nomura
Department of Plastic and Reconstructive Surgery, St. Mary’s Hospital, Kurume, Japan
,
Toshinori Hokazono
Department of Plastic and Reconstructive Surgery, St. Mary’s Hospital, Kurume, Japan
,
Yuuki Uchida
Department of Plastic and Reconstructive Surgery, St. Mary’s Hospital, Kurume, Japan
› Author Affiliations

Harvesting grafts from the anterior iliac bone has been associated with various complications. A 50-year-old woman presented to our department with a chief complaint of right inguinal swelling and pain. Autologous bone grafts had been harvested on two previous occasions from the right anterior iliac crest for use in the reconstruction of multiple facial fractures. Computed tomography and magnetic resonance imaging revealed a full-thickness bone defect in the right anterior iliac crest. A mass was noted in the right gluteus minimus, while a multilocular cystic mass extended from the right iliac crest defect to the right inguinal region. Both the inguinal mass and gluteal mass were removed under general anesthesia. Following histopathological analysis, the gluteal mass was diagnosed as a venous malformation(VM). Based on the patient’s clinical course, iliac bone graft harvesting and trauma to the gluteal region triggered hemorrhaging from the VM. Blood components leaked out from the fragile portion of the iliac bone defect, forming a cystic lesion that developed into the inguinal mass. In this case, a coincidental VM resulted in a rare complication of iliac bone graft harvesting. These sequelae could have been avoided by planning for more appropriate ways to collect the grafts.



Publication History

Received: 18 September 2017

Accepted: 09 January 2018

Article published online:
03 April 2022

© 2018. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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  • REFERENCES

  • 1 Almaiman M, Al-Bargi HH, Manson P. Complication of anterior iliac bone graft harvesting in 372 adult patients from May 2006 to May 2011 and a literature review. Craniomaxillofac Trauma Reconstr 2013; 6: 257-66
  • 2 Chou AS, Hung CF, Tseng JH. et al. Pseudoaneurysm of the deep circumflex iliac artery: a rare complication at an anterior iliac bone graft donor site treated by coil embolization. Chang Gung Med J 2002; 25: 480-4
  • 3 Neo M, Matsushita M, Morita T. et al. Pseudoaneurysm of the deep circumflex iliac artery: a rare complication at an anterior iliac bone graft donor site. Spine (Phila Pa 1976) 2000; 25: 1848-51
  • 4 Ahlmann E, Patzakis M, Roidis N. et al. Comparison of anterior and posterior iliac crest bone grafts in terms of harvest-site morbidity and functional outcomes. J Bone Joint Surg Am 2002; 84-A: 716-20
  • 5 Hamad MM, Majeed SA. Incisional hernia through iliac crest defects: a report of three cases with a review of the literature. Arch Orthop Trauma Surg 1989; 108: 383-5
  • 6 Lee BB, Baumgartner I, Berlien P. et al. Diagnosis and treatment of venous malformations. consensus document of the international union of phlebology (IUP): updated-2013. Int Angiol 2015; 34: 97-149
  • 7 Oldfield M. Iliac hernia after bone grafting. Lancet 1945; 245: 810-2
  • 8 Auleda J, Bianchi A, Tibau R. et al. Hernia through iliac crest defects: a report of four cases. Int Orthop 1995; 19: 367-9
  • 9 Velchuru VR, Satish SG, Petri GJ. et al. Hernia through an iliac crest bone graft site: report of a case and review of the literature. Bull Hosp Jt Dis 2006; 63: 166-8