DOI: https://doi.org/10.36347/sjmcr.2025.v13i06.026

Pages: 1411-1413

Introduction: Persistent sciatic artery (PSA) is a rare congenital vascular anomaly of the lower limb, usually discovered incidentally. It is typically asymptomatic but can become clinically significant in the context of trauma or vascular complications. Case Report: We report the case of a 25-year-old male with no prior medical history, admitted to the emergency department in hypovolemic shock following a stab wound. Clinical examination revealed a deep laceration on the lateral aspect of the mid-thigh, with active and profuse bleeding. An emergency CT angiography revealed a left-sided persistent sciatic artery, which was the dominant vessel supplying the lower limb. The artery had been injured along its aberrant course, explaining the severity of the hemorrhage. This incidental finding guided the surgical management. Discussion: The PSA arises from the persistence of the embryonic axial artery. Its prevalence is low (<0.05%) and it is most often discovered incidentally, during imaging or following complications such as aneurysm or embolism. This case is notable for its traumatic presentation and for involving a dominant PSA, which is a rare variant. A review of the literature is included to provide context for this unusual presentation. Conclusion: This case highlights the importance of considering rare vascular anomalies in traumatic settings, as early recognition can significantly impact diagnosis and management strategies.