Sakamoto Akio, Okamoto Takeshi, Matsuda Shuichi
Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Shogoin, Kawahara-cho 54, Sakyo-ku, Kyoto 606-8507, Japan.
Biomed Res Int. 2017;2017:4634350. doi: 10.1155/2017/4634350. Epub 2017 May 31.
Chronic expanding hematoma is characterized by continuous growth of a blood collection. We analyzed the clinical features of 7 patients with chronic expanding hematomas in the extremities, with an average age of 65.6 years. All lesions occurred in the lower extremities, with 4 seen in the thigh and 3 in the knee region. Six patients had subcutaneous hematomas, while 1 was deep-seated in the thigh. The magnetic resonance features of the lesion were compatible with those of a standard hematoma. A low signal intensity on T1- and T2-weighted imaging at the pseudocapsule was also characteristic. Cystic features were seen in 5 of 7 patients. All lesions were resected together with their pseudocapsule. In the subcutaneous lesions, it was necessary to resect adherent fascia, with or without involved skin. In the deep-seated thigh lesion, the common peroneal nerve was completely adherent to the pseudocapsule, a phenomenon from absence of the common peroneal nerve which appeared after resection. Chronic expanding hematomas of the extremities are predominantly located in the subcutaneous tissue of the lower extremity. The surrounding pseudocapsule is adherent to the adjacent tissues, and clinicians must be aware of this, especially when resecting a deep-seated lesion.
慢性扩展性血肿的特征是血肿持续增大。我们分析了7例四肢慢性扩展性血肿患者的临床特征，平均年龄为65.6岁。所有病变均发生在下肢，其中4例位于大腿，3例位于膝关节区域。6例为皮下血肿，1例位于大腿深部。病变的磁共振特征与标准血肿相符。假包膜在T1加权成像和T2加权成像上呈低信号强度也是其特征。7例患者中有5例可见囊性特征。所有病变均与其假包膜一并切除。对于皮下病变，无论是否累及皮肤，都有必要切除粘连的筋膜。在大腿深部病变中，腓总神经完全粘连于假包膜，切除后出现腓总神经缺失的现象。四肢慢性扩展性血肿主要位于下肢皮下组织。周围的假包膜与相邻组织粘连，临床医生必须意识到这一点，尤其是在切除深部病变时。
