Galantini Gianfranco, Mushtaq Bakhtawar, Ottaway Jesse, Long Charles D
From the Department of Surgery, Jefferson Abington Hospital, Abington, Pa.
Division of Plastic Surgery, Jefferson Abington Hospital, Abington, Pa.
Plast Reconstr Surg Glob Open. 2024 Sep 4;12(9):e6133. doi: 10.1097/GOX.0000000000006133. eCollection 2024 Sep.
Chronic expanding hematoma (CEH) is a rare entity that poses diagnostic and therapeutic challenges due to persistent growth, risk of recurrence, and potential for blood loss anemia. The most common etiologies of CEH are trauma or surgery. It is thought to occur due to irritant effects of blood breakdown products, causing bleeding from capillaries in chronic granulation tissue. Although treatment of CEH is variable, complete surgical excision of the hematoma and its pseudocapsule is the gold standard. We present a case of a 15-year CEH that was initially treated with limited evacuation of the hematoma and cavity decortication, resulting in recurrence. Ultimately, the patient was managed with complete excision of the pseudocapsule, closure of the cavity with quilting sutures, application of an absorbable hemostatic agent, and placement of a large drain, resulting in a successful outcome. This case highlights the efficacy of a comprehensive surgical plan in addressing CEH, emphasizing the importance of pseudocapsule excision in its entirety to prevent recurrence.
慢性扩展性血肿（CEH）是一种罕见的病症，因其持续生长、复发风险以及失血导致贫血的可能性，给诊断和治疗带来了挑战。CEH最常见的病因是外伤或手术。其被认为是由于血液分解产物的刺激作用，导致慢性肉芽组织中的毛细血管出血。尽管CEH的治疗方法多样，但完整切除血肿及其假包膜是金标准。我们报告一例15年的CEH病例，该病例最初采用有限的血肿清除和腔壁剥脱术治疗，结果复发。最终，患者通过完整切除假包膜、用褥式缝线关闭腔隙、应用可吸收止血剂以及放置大引流管进行治疗，取得了成功的结果。该病例突出了综合手术方案在处理CEH方面的疗效，强调了完整切除假包膜以防止复发的重要性。
