Renou Amélie, Moeuf Yoann, Obadia Edouard, Janklewicz Philippe, Couturier Brigitte, Chalumeau-Lemoine Ludivine, Chelha Riad, Galbois Arnaud
Altern Ther Health Med. 2019 Mar;25(2):46-48.
Morel-Lavallée lesions are posttraumatic hemolymphatic collections related to shearing injury of variable mechanism (severe trauma or low-velocity crush injury), resulting in disruption of interfacial planes between subcutaneous soft tissue and muscle and perforating lymphatics and blood vessels. A 69-y-old woman, without medical history, was admitted to the emergency ward for important pain located from her behind to the anterior face of the thighs. Physical examination revealed large semirecent hematoma with a large soft fluctuant area with hypermobility of the skin and cutaneous hyperesthesia, spreading from her behind to the anterior face of her thigs. Her symptoms were typical of a Morel-Lavallée lesion. The ultrasound examination revealed hypoechoic heterogeneous compressible fluid containing fat debris with irregular margins and lobular shape, localized between subcutaneous fat and deep fascia, without flow on color Doppler, confirming the acute Morel-Lavallée lesion. After evacuation by needle puncture, the collection reappearance was probably due to hemolymphatic fluid corresponding to type 1 of the Mellado and Bencardino classification of Morel-Lavallée lesions. Patients and Physicians should be aware of the worsening effects of balneotherapy on skin hematoma to prevent dramatic extension of Morel-Lavallée lesions.
莫雷尔-拉瓦利损伤是一种创伤后血淋巴性积液，与多种机制的剪切伤（严重创伤或低速挤压伤）相关，导致皮下软组织与肌肉之间的界面平面以及穿通性淋巴管和血管遭到破坏。一名69岁无病史女性因从臀部至大腿前侧的剧痛被收治入急诊病房。体格检查发现有大片近期形成的血肿，伴有一个大的柔软波动区域，皮肤活动度增加且有皮肤感觉过敏，范围从臀部蔓延至大腿前侧。她的症状是典型的莫雷尔-拉瓦利损伤。超声检查显示低回声不均匀的可压缩液体，含有脂肪碎屑，边缘不规则，呈小叶状，位于皮下脂肪与深筋膜之间，彩色多普勒显示无血流信号，证实为急性莫雷尔-拉瓦利损伤。经穿刺抽液后，积液再次出现可能是由于符合莫雷尔-拉瓦利损伤梅拉多和本卡尔迪诺分类中1型的血淋巴液。患者和医生应意识到温泉疗法对皮肤血肿的不良影响，以防止莫雷尔-拉瓦利损伤急剧扩大。
