Brady Christopher M, Amiraian Dana E, Agely Ali
Department of Radiology, Mayo Clinic, Jacksonville, FL, USA.
Radiol Case Rep. 2024 Aug 6;19(10):4565-4568. doi: 10.1016/j.radcr.2024.07.048. eCollection 2024 Oct.
The Morel-Lavallée lesion is an uncommon closed degloving injury that most often occurs in the setting of high-energy trauma and can be associated with other traumatic injuries, including fractures of the pelvis, acetabulum, or femur. The superficial soft tissues are forcibly separated from the underlying deep fascia, resulting in damage to penetrating blood vessels and lymphatics. A fluid collection consisting of lymph, blood, and/or necrotic tissue subsequently develops and is most common in the region of the greater trochanter. Awareness of this entity is important to prevent a delay in diagnosis and decrease the risk of potential complications such as pseudocyst formation, pressure necrosis of the overlying skin, chronic pain, and infection. We present the case of a 49-year-old man who noticed a fluid collection in his right lateral upper thigh 1 week after slipping and falling down half a flight of stairs. Ultrasound demonstrated a fusiform fluid collection between the subcutaneous fat and underlying deep fascia, consistent with a Morel-Lavallée lesion. After reviewing various treatment options, the patient elected to undergo nonsurgical management. The lesion persisted but substantially improved 6 weeks after the initial injury. This case underscores the need to consider Morel-Lavallée lesions in the appropriate clinical context.
莫雷尔-拉瓦利埃损伤是一种罕见的闭合性脱套伤，最常发生于高能创伤情况下，且可能与其他创伤性损伤相关，包括骨盆、髋臼或股骨骨折。浅表软组织被强行与深层筋膜分离，导致穿支血管和淋巴管受损。随后会形成一个由淋巴、血液和/或坏死组织组成的液体积聚，最常见于大转子区域。认识到这种情况对于防止诊断延误以及降低潜在并发症（如假囊肿形成、覆盖皮肤的压迫性坏死、慢性疼痛和感染）的风险很重要。我们报告一例49岁男性病例，该患者在从半层楼梯滑倒1周后，发现右侧大腿外侧上部有液体积聚。超声显示皮下脂肪与深层筋膜之间有梭形液体积聚，符合莫雷尔-拉瓦利埃损伤。在评估了各种治疗方案后，患者选择接受非手术治疗。损伤持续存在，但在初次受伤6周后有显著改善。该病例强调了在适当的临床背景下考虑莫雷尔-拉瓦利埃损伤的必要性。
