Lin Hsing-Lin, Lee Wei-Che, Kuo Liang-Chi, Chen Chao-Wen
Department of Trauma, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
Am J Emerg Med. 2008 Feb;26(2):254.e5-6. doi: 10.1016/j.ajem.2007.05.006.
In the emergency department, we frequently manage patients with multiple contusions and bruise over the trunk without severe injuries. Emergency department discharge is a common option for these patients, and we may neglect the existence of closed internal degloving injury, which is a soft tissue injury with pelvic trauma, combining the subcutaneous tissue torn away from the underlying fascia followed by a cavity being filled with hematoma and liquefied fat created in the next few days (Harefuah 2006;145:111-3:66, J Trauma 1997;42:1046). We report the unusual occurrence of this entity in an 18-year-old man. He encountered a scooter accident and experienced a few days of hospitalization because of thoracispinal (T10 and T11) process fracture. He was discharged, but a fluctuating mass developed at the lumbar area 10 days later. The comprehensive survey excluded the cerebrospinal fluid leakage associated with spinal fracture, and internal degloving injury was diagnosed. Percutaneous drainage with compressive bondage was aggressively used. Even though the treatment course was time consuming, the lesion eventually disappeared 10 months after his first visit.
在急诊科，我们经常会处理一些躯干有多处挫伤和瘀伤但无严重损伤的患者。对于这些患者，急诊出院是常见的选择，而我们可能会忽略闭合性内部脱套伤的存在，这是一种伴有骨盆创伤的软组织损伤，表现为皮下组织从其下方的筋膜分离，随后在接下来的几天内形成一个充满血肿和液化脂肪的腔隙（《哈雷富阿》2006年；145:111 - 3:66，《创伤杂志》1997年；42:1046）。我们报告了一名18岁男性中这种罕见情况的发生。他遭遇了一起踏板车事故，因胸腰椎（T10和T11）椎体骨折住院治疗了几天。他出院了，但10天后腰部出现了一个波动的肿块。全面检查排除了与脊柱骨折相关的脑脊液漏，诊断为内部脱套伤。积极采用了经皮引流并加压包扎。尽管治疗过程耗时较长，但病变最终在他首次就诊10个月后消失。
