Cruz Nelimar, Jiménez Ricardo
University of Puerto Rico, Medical Sciences Campus, Department of Surgery, PO BOX 365067, San Juan, PR, 00936-5067, United States.
University of Puerto Rico, Medical Sciences Campus, Department of Surgery, Plastic Surgery Division, PO BOX 365067, San Juan, PR, 00936-5067, United States.
Int J Surg Case Rep. 2021 Apr;81:105733. doi: 10.1016/j.ijscr.2021.105733. Epub 2021 Mar 6.
Morel-Lavallée lesions are closed degloving injuries in which the skin and subcutaneous tissues separate from the underlying fascia secondary to a shearing force. These injuries are uncommon and can be misdiagnosed in acute settings. If treated incorrectly, they can recur, causing complications requiring multiple surgical interventions. Therefore, it is important to discuss the clinical presentation and imaging characteristics in order to improve their diagnosis and management.
This is the case of a 44-year-old male patient with a Morel-Lavallée lesion of the left thigh that presented 25 years after trauma. He was successfully treated with open surgical excision. The patient underwent multiple surgical interventions before the lesion was accurately diagnosed and treated.
Morel-Lavallée injuries can lead to chronic symptoms, such as pain and swelling, affecting the patient's quality of life. Treatment options include minimally invasive procedures, such as compression bandages or percutaneous drainage. However, if diagnosed late, a fibrotic capsule can form, which may require surgical excision. Our patient was diagnosed more than 20 years after the trauma. Earlier noninvasive treatment options were unsuccessful.
The patient was treated with open surgical excision of the chronic lesion. There was no report of any recurrence up to 10 months after surgery. Such lesion treatments should be guided based on the chronicity of the injury and the patient's symptoms. To the best of our knowledge, this is the first case with such delayed presentation.
莫雷尔-拉瓦利损伤是一种闭合性脱套伤，由于剪切力作用，皮肤和皮下组织与深层筋膜分离。这些损伤并不常见，在急性情况下可能会被误诊。如果治疗不当，可能会复发，导致需要多次手术干预的并发症。因此，讨论其临床表现和影像学特征对于改善诊断和治疗很重要。
这是一名44岁男性患者，左大腿莫雷尔-拉瓦利损伤，创伤后25年出现。他通过开放性手术切除成功治愈。该患者在病变得到准确诊断和治疗之前接受了多次手术干预。
莫雷尔-拉瓦利损伤可导致慢性症状，如疼痛和肿胀，影响患者生活质量。治疗选择包括微创程序，如压迫绷带或经皮引流。然而，如果诊断较晚，可能会形成纤维化包膜，这可能需要手术切除。我们的患者在创伤后20多年才被诊断出来。早期的非侵入性治疗方法均未成功。
该患者接受了慢性病变的开放性手术切除。术后10个月内没有任何复发报告。此类病变的治疗应根据损伤的慢性程度和患者症状进行指导。据我们所知，这是首例出现如此延迟表现的病例。
