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[莫雷尔-拉瓦利埃损伤:创伤后的延迟症状]

[The Morel-Lavallée-lesion: delayed symptoms after trauma].

作者信息

van Vugt Jeroen L A, Beks Sabine B J C, Borghans Rob A P, Hoofwijk A G M Ton

机构信息

Orbis Medisch Centrum, Sittard, the Netherlands.

出版信息

Ned Tijdschr Geneeskd. 2013;157(23):A5914.

Abstract

BACKGROUND

The Morel-Lavallée lesion is a post-traumatic collection of fluid arising after a 'closed degloving injury' has caused the separation of the skin and subcutis from the underlying muscular fascia. It usually occurs in the trochanteric region or proximal thigh.

CASE DESCRIPTION

A 36-year-old obese man was referred to the emergency department by his general practitioner for fever and pain in the right lower abdominal quadrant. Blood testing revealed elevated infection parameters. As appendicitis was suspected, a CT scan of the abdomen was performed. This revealed a Morel-Lavallée lesion, which he had sustained 9 months earlier when he had been hit by a car while riding his bicycle. A rapid recovery ensued after ultrasound-guided percutaneous drainage and treatment with antibiotics.

CONCLUSION

A Morel-Lavallée lesion, which could manifest even months later, should be considered after any traumatic injury. Ultrasound, CT and MRI are useful tools for proper diagnosis. There is no consensus about treatment in either the acute or the chronic phase to date.

摘要

背景

莫雷尔-拉瓦利埃损伤是一种创伤后积液,发生于“闭合性脱套伤”导致皮肤和皮下组织与深层肌肉筋膜分离之后。它通常发生在转子区或大腿近端。

病例描述

一名36岁肥胖男性被全科医生转诊至急诊科,主诉右下腹发热和疼痛。血液检查显示感染指标升高。由于怀疑为阑尾炎,遂进行腹部CT扫描。结果发现一处莫雷尔-拉瓦利埃损伤,该损伤是他9个月前骑自行车时被汽车撞到所致。在超声引导下经皮引流并使用抗生素治疗后,患者迅速康复。

结论

任何创伤后都应考虑到莫雷尔-拉瓦利埃损伤,即便其可能在数月后才出现。超声、CT和MRI是进行准确诊断的有用工具。目前对于急性期和慢性期的治疗尚无共识。

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