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莫雷尔-拉瓦利埃损伤作为出血性休克的罕见病因:病例报告及文献综述

Morel-Lavallée lesion as an unusual cause of hemorrhagic shock: Case report and review of literature.

作者信息

Daghmouri Mohamed Aziz, Ben Ismail Imen, Ouesleti Maroua, Tarhouni Mohamed Amine, Faten Olfa, Rebai Sabeur, Zoghlemi Ayoub, Rebai Lotfi

机构信息

Department of Anesthesia, Trauma Center of Ben Arrous, Tunisia.

Department of Visceral Surgery, Trauma Center of Ben Arrous, Tunisia.

出版信息

Int J Surg Case Rep. 2020;77:759-761. doi: 10.1016/j.ijscr.2020.11.108. Epub 2020 Nov 21.

Abstract

INTRODUCTION

Morel-Lavallée syndrome (MLS) is considered as a rare entity and hemorrhagic shock as a complication is uncommon.

PRESENTATION OF CASE

We report the case of a 56-year- old man who presented to the emergency department after a road traffic accident. Initially, the patient was hemodynamically unstable (heart rate 160 beats/min and blood pressure 65/30). Physical examination revealed multiple lacerations on his back and a gradually expanding large subcutaneous hematoma on the left flank extending to the hip and left leg. Fluid resuscitation was rapidly initiated. After stabilizing his hemodynamic status, a full-body computed tomography was performed revealing, apart from a small unilateral pneumothorax and a stable pelvis fracture, an extensive Morel-Lavallée lesion in the lumbar region extending to the hip and both legs. The patient was then transferred to a surgical intensive care unit for further resuscitation and surgical drainage of the collection followed by continuous suction was performed. Even though rare, Hemorrhagic shock is one of the threatening complications of Morel-Lavallée lesions and should be kept in mind by every traumatologist and emergency doctor.

CONCLUSION

We report a case about a rare complication of MLS which is hemorrhagic shock in order to highlight the importance of making the diagnosis, which can be unrecognized, and initiate an adequate treatment on time.

摘要

引言

莫雷尔-拉瓦利综合征(MLS)被认为是一种罕见疾病,作为其并发症的失血性休克并不常见。

病例介绍

我们报告一例56岁男性患者,该患者在道路交通事故后被送往急诊科。最初,患者血流动力学不稳定(心率160次/分钟,血压65/30)。体格检查发现其背部有多处裂伤,左侧腹部有一个逐渐扩大的巨大皮下血肿,延伸至臀部和左腿。迅速开始进行液体复苏。在其血流动力学状态稳定后,进行了全身计算机断层扫描,结果显示,除了少量单侧气胸和稳定的骨盆骨折外,在腰椎区域有广泛的莫雷尔-拉瓦利损伤,延伸至臀部和双腿。随后患者被转至外科重症监护病房进行进一步复苏,并对血肿进行手术引流,之后进行持续吸引。尽管罕见,但失血性休克是莫雷尔-拉瓦利损伤的威胁性并发症之一,每位创伤科医生和急诊科医生都应牢记。

结论

我们报告了一例关于MLS罕见并发症即失血性休克的病例,以强调做出诊断的重要性,因为该诊断可能未被识别,需及时启动适当治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42e0/7718137/f44af9bc9428/gr1.jpg

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