Blue Jays hold on for wild win over Orioles, but Guerrero Jr. leaves with injury

Randal Grichuk hit a grand slam with two outs in the ninth inning, and the Toronto Blue Jays rebounded from an ineffective start by Clay Buchholz to rally past the Baltimore Orioles 11-10 on Wednesday night.

Randal Grichuk sparks Toronto rally with grand slam in 9th

Randal Grichuk of the Toronto Blue Jays celebrates with teammates after hitting a grand slam in the ninth inning against the Baltimore Orioles at Camden Yards on Wednesday. (Will Newton/Getty Images)

After Vladimir Guerrero Jr. and Clay Buchholz left the game under radically different circumstances, Randal Grichuk delivered the decisive blow in an improbable Toronto victory.

The Blue Jays overcame an ineffective start by Buchholz, using a grand slam by Grichuk with two outs in the ninth inning to beat the Baltimore Orioles 11-10 on Wednesday night.

Grichuk's 30th home run highlighted a six-run ninth that began with Toronto trailing 9-5. The shot came off Miguel Castro (1-3), who was charged with all six runs.

Guerrero Jr. was removed in the ninth after being shaken up making a hard slide into second base.

"It was the rib," manager Charlie Montoyo said.

Guerrero was wearing a bandage over his left rib cage, but it was unclear if he would miss any or all of Toronto's final 10 games.

WATCH | Grichuk hits grand slam in 9th inning:

Randal Grichuk hit a grand slam in the ninth inning, leading Toronto to a 11-10 come from behind win. 1:48

Brock Stewart (4-0) worked the eighth and Derek Law finished for his fifth save, retiring Trey Mancini on a bases-loaded grounder to end a game that lasted 4 hours, 8 minutes.

Homers by Jonathan Villar and Anthony Santander in the fourth inning put Baltimore ahead 7-1 and ended another disappointing outing by Buchholz. He allowed 10 hits, seven for extra bases, in 3 2/3 innings and left with a 6.48 ERA.

"Terrible," Buchholz said. "It's what I told [catcher] Reese [McGuire] whenever Charlie came out and got the ball from me. I tapped him on the facemask and told him 'That's what happens when you don't execute your pitches when you need to execute them.' It's not the first time I've given up seven runs."

The oldest man on a team rebuilding with youth, Buchholz has spent more days on the injured list than on the active roster. The 35-year-old started on the IL with an elbow strain and was sidelined with right shoulder inflammation from May 9-Aug. 24.

Uncertain future for Buchholz

This was the shortest of his 10 starts this season. Buchholz missed time last year with Arizona because of elbow and oblique injuries, and in 2017 he had season-ending elbow surgery after making two starts in April.

Now, 12 years after throwing a no-hitter against the Orioles for Boston in his second major league start, Buchholz faces an uncertain future after he completes the final days of a one-year deal he signed in March.

Since going 81-61 with the Red Sox during a 10-year span, Buchholz is 8-8 over the past three seasons.

Vladimir Guerrero Jr. walks off the field after an apparent injury during the ninth inning. (Will Newton/Getty Images)

In an eventful first inning, Dylan Bundy struck out Teoscar Hernandez with the bases loaded to end the top half and Derek Fisher opened the bottom half by reaching over the left-field wall to rob Villar of a home run. With two outs, Santander, Rio Ruiz and Austin Hays doubled in succession for a 2-0 lead.

It was 4-1 in the fourth before Villar hit his 23rd homer , Trey Mancini singled and Santander sent a 1-2 pitch deep into the right-field seats.

Buchholz never turned to follow the path of the ball. He simply motioned for another baseball, caught it barehanded and trudged back to the mound.

An instant after that, Montoyo went to the mound and took that ball from Buchholz.

But Baltimore couldn't hold the lead.

"Miguel Castro has been throwing the ball great the past couple months," manager Brandon Hyde said. "He just had a tough night."