Leach Samuel Edward Thomas, Wotherspoon Mark, King Leonard
Department of Radiology, Salisbury NHS Foundation Trust, Salisbury, United Kingdom.
Hampshire Hospitals NHS Foundation Trust, Basingstoke, United Kingdom.
BJR Case Rep. 2020 May 6;6(3):20190120. doi: 10.1259/bjrcr.20190120. eCollection 2020 Sep 1.
Morel-Lavallée lesions are chronic seromas due to closed degloving injuries, resulting from blunt trauma. They most commonly occur over the greater trochanteric, gluteal and flank regions. We present a case of retrosacral Morel-Lavallée lesion. Initial ultrasound demonstrated a fluid collection lying between the subcutaneous fat and the underlying fascia superficial to the sacrum. Following repeated ultrasound-guided aspirations, further recurrence of a superficial pre-sacral seroma was confirmed with MRI. Ultrasound-guided aspiration was performed and 100 mg of injectable doxycycline was instilled into the lesion. 4 months after sclerotherapy, the patient was asymptomatic, and follow-up MRI demonstrated no residual fluid collection or complication. This case demonstrates the value of using MRI in conjunction with ultrasound to characterize Morel-Lavallée lesions in an atypical site and in confirming response to treatment, in addition to the use of sclerotherapy for treatment of a lesion refractory to repeated aspiration.
莫雷尔-拉瓦利损伤是由钝性创伤导致的闭合性脱套伤引起的慢性血清肿。它们最常发生在大转子、臀部和侧腹区域。我们报告一例骶骨后方莫雷尔-拉瓦利损伤病例。最初的超声检查显示在皮下脂肪与骶骨前方的深筋膜之间有液体积聚。在多次超声引导下抽吸后，MRI证实骶骨前方浅表血清肿进一步复发。进行了超声引导下抽吸，并向损伤部位注入100毫克注射用强力霉素。硬化治疗4个月后，患者无症状，随访MRI显示无残留液体积聚或并发症。该病例表明，除了使用硬化疗法治疗反复抽吸无效的损伤外，联合使用MRI和超声对于在非典型部位表征莫雷尔-拉瓦利损伤以及确认治疗反应具有重要价值。
