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大型莫雷尔-拉瓦利埃病变的内镜手术治疗

Endoscopic surgical management of a large Morel-Lavallée lesion.

作者信息

Walls Andrew, McMahon Samuel E, MacDonald Jonathan, Bunn Jonathan

机构信息

Trauma and Orthopaedics, Southern Health and Social Care Trust, Portadown, UK.

Trauma and Orthopaedics, Western Health and Social Care Trust, Londonderry, UK.

出版信息

BMJ Case Rep. 2017 Sep 23;2017:bcr-2017-221343. doi: 10.1136/bcr-2017-221343.

Abstract

The Morel-Lavallée lesion is a closed degloving injury that usually occurs following high-energy trauma. We present a case demonstrating endoscopic management of this lesion. A 44-year-old man fell from scaffolding. Initial assessment demonstrated no significant injury. An ultrasound scan 2 days post injury revealed a large fluid collection along the lateral right thigh. This subsequently became infected and did not respond to antibiotic therapy.Due to the extent of the lesion, we were reluctant to perform a traditional open drainage. An endoscopic probe was inserted at the proximal and distal poles of the lesion and the wound debrided.This resulted in a rapid improvement in symptoms and a complete resolution of the lesion at 1 year postsurgery, with no wound-associated morbidity.This is only the second description of endoscopic debridement of a large, acute Morel-Lavallée lesion, with an excellent outcome.

摘要

莫雷尔-拉瓦利损伤是一种闭合性脱套伤,通常发生在高能创伤后。我们报告一例展示该损伤内镜治疗的病例。一名44岁男性从脚手架上跌落。初始评估未发现严重损伤。受伤2天后的超声扫描显示右大腿外侧有大量液体积聚。该液体积聚随后发生感染,对抗生素治疗无反应。由于损伤范围较大,我们不愿进行传统的开放引流。在内镜下将探头插入损伤的近端和远端,对伤口进行清创。这导致症状迅速改善,术后1年损伤完全消退,且无伤口相关并发症。这是第二例关于大型急性莫雷尔-拉瓦利损伤内镜清创的描述,结果极佳。

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