Morel-Lavallee Lesion: A Forgotten Cause of Bleeding in Trauma
Case study: Morel-Lavallee Lesion
Abstract
The Morel-Lavallee lesion is a rare soft tissue injury that occurs due to traumatic shearing force on skin surface causing separation of skin and subcutaneous tissue resulting in hematoma. This case report depicts a 22-year-old gentleman who was involved in a motor vehicle accident. He complained of pain and swelling over lower back. He was treated for soft tissue injury and admitted for pain control. One day post-trauma, he complained of increased swelling over the back. His hemoglobin dropped from 12.2g/dL to 10.7g/dL. Diagnosis of Morel-Lavallae lesion was made. Initially no surgical intervention was planned. However, in view of worsening of swelling, bedside aspiration was performed and subsequently a pigtail catheter was inserted to drain the hematoma. In total, 2.05 litre of liquefied hematoma was drained. Thus, Morel-Lavallee lesion is an uncommon soft tissue injury that can cause significant bleeding following trauma.
Keywords :
degloving injuries,
hematoma,
trauma,
Abstrak
“Morel-Lavallee lesion” adalah kecederaan tisu lembut yang berlaku akibat daripada daya trauma pada permukaan kulit. Ini menyebabkan permisahan lapisan kulit and tisu subkutaneus dan menghasilkan darah beku. Laporan kes ini menggambarkan seorang pesakit lelaki berusia 22 tahun yang terlibat dalam kemalangan jalan raya. Dia mengadu kesakitan dan bengkak pada bahagian belakang badan. Dia telah dirawat sebagai kecederaan tisu lembut dan dimasukkan ke hospital untuk mengawal tahap kesakitan kecederaan. Pada hari pertama selepas kemalangan, bahagian belakang badan pesakit semakin membengkak. Tahap hemoglobin pesakit menurun dari 12.2 g/dL ke 10.7 g/dL. Diagnosis “Morel-Lavallee lesion” telah dibuat. Pada mulanya tiada prosedur pembedahan dirancang. Walau bagaimanapun, memandangkan kebengkakan semakin meningkat, prosedur aspirasi di sisi katil dan sedutan melaui kateter jenis ekor-khinzir telah dibuat untuk mengalirkan darah beku. Jumlah cecair darah beku dikeluarkan adalah sebanyak 2.05 liter. Kesimpulannya, “Morel-Lavallee lesion” adalah kecederaan tisu lembut yang jarang berlaku tetapi mampu menyebabkan pendarahan yang serius selepas trauma berlaku.
Kata Kunci :
darah beku,
kecederaan,
trauma,
Correspondance Address
Tan Toh Leong. Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Tel: +60391456482 Fax: +60391456577 E-mail: sebastianttl@yahoo.co.uk
