21: Trauma to the Flank and Buttocks

Question 1

The flank is defined as

Answer 1

the region between the anterior and posterior axillary lines,
bordered superiorly by the sixth ribs
and inferiorly by the iliac crests

Question 2

Remarks on imaging of flank injuries

Answer 2

No single method is currently considered sufficient to rule out significant injuries and a combination of modalities, along with observation, is recommended

Question 3

The gluteal region is divided into

Answer 3

an upper zon and a lower zone by a line drawn at the level of the trochanters

Question 4

most commonly injured vasculature in gluteal stab injuries

Answer 4

superior gluteal artery

Question 5

Remarks on the gluteal zones

Answer 5

Most of the major pelvic vasculature and organs reside in the upper zone;
therefore, penetrating wounds in the upper zone have a higher risk of major injury compared to wounds in the lower zone

Question 6

Gluteal stab wounds nonoperative management

Answer 6

Local wound exploration
If without muscle violation, observation with serial exams

If with muscle violation, CT and sigmoidoscopy, plus cystography for hematuria