Kalaria Shana S, Boson Alexis, Griffin Lance W
Division of Plastic Surgery, University of Texas Medical Branch, Galveston, TX.
School of Medicine, University of Texas Medical Branch, Galveston, TX.
Wounds. 2020 Apr;32(4):E23-E26.
A Morel-Lavallée lesion (MLL) is a rare and aesthetically concerning condition caused by a shearing force between subcutaneous fat and underlying fascia. Subsequent seroma formation occurs after the initial trauma of a crush injury, ligamentous sprain, or abdominal liposuction. Misdiagnosed lesions lead to inadequate treatment and are a source of chronic pain.
The case of a 33-year-old woman who presented with a large, painful subacute MLL of the left thigh after being run over by a truck 3 weeks prior is reported. Physical examination revealed severe hyperesthesia and fluctuance of the left thigh. After confirmation of the fluid collection by X-ray and computed tomography angiogram, the authors performed liposuction of the cavity and seroma wall to evacuate and treat the lesion. Postoperative care consisted of a temporary drain, thigh compression, and oral antibiotics. Immediate reduction in size was appreciated intraoperatively with no reaccumulation of fluid at postoperative visits on week 1 and week 6. The pathology report confirmed seroma etiology, and all cultures of the fluid returned negative. At the end of her postoperative course, the patient reported a reduction in pain and no recurrence of her symptoms.
This case of MLL was diagnosed early and successfully treated with liposuction, resulting in an acceptable cosmetic outcome. It is the authors' hope that this case report will lead to earlier diagnosis and proper treatment of MLLs.
莫雷尔-拉瓦利埃损伤（MLL）是一种罕见且影响美观的疾病，由皮下脂肪与深层筋膜之间的剪切力引起。在挤压伤、韧带扭伤或腹部抽脂的初始创伤后会形成血清肿。病变误诊会导致治疗不充分，并成为慢性疼痛的根源。
报告了一名33岁女性的病例，该女性在3周前被卡车碾压后出现左大腿巨大、疼痛的亚急性莫雷尔-拉瓦利埃损伤。体格检查发现左大腿有严重的感觉过敏和波动感。通过X线和计算机断层血管造影确认积液后，作者对腔隙和血清肿壁进行了抽脂以排出并治疗病变。术后护理包括放置临时引流管、大腿加压和口服抗生素。术中可见尺寸立即缩小，术后第1周和第6周复诊时无液体再次积聚。病理报告证实为血清肿病因，液体的所有培养结果均为阴性。在术后疗程结束时，患者报告疼痛减轻且症状未复发。
该例莫雷尔-拉瓦利埃损伤早期诊断并成功通过抽脂治疗，获得了可接受的美容效果。作者希望本病例报告能促使莫雷尔-拉瓦利埃损伤得到更早的诊断和恰当的治疗。
