Department of Surgery, Cliniques Universitaires du Graben, Faculty of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of Congo.
Department of Infectious Diseases, Faculty of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of Congo.
J Med Case Rep. 2021 Jul 19;15(1):383. doi: 10.1186/s13256-021-02891-6.
Morel-Lavallée lesions are posttraumatic, closed degloving injuries in which the skin and subcutaneous tissue are separated abruptly from superficial underlying fascia. This condition leads to an effusion containing hemolymph and necrotic fat. Magnetic resonance imaging, when available, is the modality of choice in the evaluation of Morel-Lavallée lesion. Early diagnosis and management is essential as any delay in diagnosis or missed lesion will lead to the effusion becoming infected or leading to extensive skin necrosis. We present a condition of a Morel-Lavallée lesion involving the scalp and complicated by conjunctival chemosis.
We report on a 3-year-old black African girl who presented a fluctuant swelling of entire scalp, extending to upper part of the face on the seventh day after a forehead trauma due to falling on a rock while playing. Skull x-ray revealed soft-tissue swelling, giving an impression of large fluid collection in the deep subcutaneous tissues with no bone fracture. A diagnosis of Morel-Lavallée lesion of the scalp complicated by conjunctival chemosis was made. The patient was managed with percutaneous drainage and compression bandage. The patient improved well and was subsequently discharged without any vision impairment. There was no recurrence of the lesion on follow-up.
The Morel-Lavallée lesion of the scalp complicated with conjunctival chemosis is a rare presentation of this condition. Prompt diagnosis and management are crucial for preventing complications. Image-guided diagnosis and treatment still remain a challenge in the setting of low-resource health facilities.
Morel-Lavallée 损伤是一种创伤后、闭合性撕脱伤，皮肤和皮下组织与浅部的深筋膜突然分离。这种情况会导致含有血液和坏死脂肪的渗出液。磁共振成像（MRI）在评估 Morel-Lavallée 损伤时是首选的检查方式。早期诊断和治疗至关重要，因为任何诊断延迟或漏诊都会导致渗出液感染或导致广泛的皮肤坏死。我们报告了一例头皮的 Morel-Lavallée 损伤，并伴有结膜水肿。
我们报告了一名 3 岁的非洲黑人女孩，在玩耍时额头撞到石头后第 7 天，出现整个头皮波动性肿胀，延伸到脸部上部。颅骨 X 线片显示软组织肿胀，印象为深部皮下组织有大量液体聚集，无骨折。诊断为头皮的 Morel-Lavallée 损伤，伴有结膜水肿。患者接受了经皮引流和加压包扎治疗。患者恢复良好，随后出院，无视力障碍。随访中未见病变复发。
头皮的 Morel-Lavallée 损伤伴发结膜水肿是这种疾病的一种罕见表现。及时诊断和治疗对于预防并发症至关重要。在资源匮乏的医疗环境中，影像引导的诊断和治疗仍然是一个挑战。
