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手套之下的致命伤:一例致命性莫雷尔-拉瓦利埃损伤病例报告

Fatal Beneath the Glove: A Case Report of Fatal Morel Lavallee Lesion.

作者信息

Manral Ishita, Manral Rahul, Anandhakrishnan T, Bansal Sandeep, Khan R N, Shivakumar K, Radhakrishna K V, Makhani C S

出版信息

Acad Forensic Pathol. 2025 Apr 13:19253621251333186. doi: 10.1177/19253621251333186.

Abstract

Road traffic accidents cause 22 deaths daily in India. Lacerations are tears or splits in skin, mucus membranes, muscles, or organs when stretched beyond their limit of elasticity. Open wounds are the second most common wounds in road traffic accidents. Attention is drawn to open wounds due to the surface discontinuity. We are reporting this case because, during the autopsy, it was crucial to examine beneath the seemingly normal skin to determine the cause of death. There was no breach in vascular integrity or bony fractures or tears to narrow down the differentials. Here we discuss a case in which a 26-year-old healthy male died from a closed degloving injury. The autopsy helped in diagnosing a Morel Lavallée lesion. The patient suffered a closed injury to his left lower limb and abdomen after being struck by a heavy motor vehicle. He underwent immediate fasciotomy and exploratory laparoscopy within 10 h of admission but unfortunately did not survive. We review the current literature and the autopsy findings, providing a comparative glimpse of the differentials that can aid in its diagnosis, even in clinical set-ups. Emergency caregivers need to consider this entity as a differential diagnosis even when the skin shows no disintegrity. This will save time in the golden hour and it could potentially save a life.

摘要

在印度,道路交通事故每天导致22人死亡。撕裂伤是指皮肤、黏膜、肌肉或器官在被拉伸至超出其弹性极限时出现的撕裂或裂开。开放性伤口是道路交通事故中第二常见的伤口。由于表面不连续,开放性伤口容易引起注意。我们报告该病例是因为在尸检过程中,检查看似正常的皮肤下方以确定死因至关重要。没有血管完整性破坏、骨折或撕裂来缩小鉴别诊断范围。在此,我们讨论一例26岁健康男性死于闭合性脱套伤的病例。尸检有助于诊断莫雷尔-拉瓦利病变。该患者被一辆重型机动车撞击后,左下肢和腹部受到闭合性损伤。他在入院后10小时内立即接受了筋膜切开术和探查性腹腔镜检查,但不幸的是未能存活。我们回顾了当前的文献和尸检结果,对有助于诊断该疾病的鉴别诊断方法进行了比较性概述,即使是在临床环境中。急诊护理人员即使在皮肤没有破损时也需要将这种情况作为鉴别诊断考虑。这将在黄金时间节省时间,并有可能挽救生命。

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