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Hemorrhagic Shock in a Patient with a Morel-Lavallée Lesion Combined with Active Arterial Bleeding without Fracture

  • Lim, Eic Ju (Department of Orthopedic Surgery, Korea University Guro Hospital) ;
  • Oh, Jong-Keon (Department of Orthopedic Surgery, Korea University Guro Hospital) ;
  • Cho, Jae-Woo (Department of Orthopedic Surgery, Korea University Guro Hospital) ;
  • Sakong, Seungyeob (Department of Orthopedic Surgery, Korea University Guro Hospital) ;
  • Cho, Jun-Min (Department of General Surgery, Korea University Guro Hospital)
  • 투고 : 2020.06.02
  • 심사 : 2020.08.31
  • 발행 : 2021.03.30

초록

A Morel-Lavallée lesion is a closed degloving injury caused by traumatic separation of the skin and subcutaneous tissue from the underlying fascia. However, since physicians tend to focus on treating the bone fracture, hemodynamic instability accompanying a Morel-Lavallée lesion can sometimes be overlooked. We report the case of a hemodynamically unstable 73-year-old man who had a Morel-Lavallée lesion of the thigh, but no femur fracture. Angiography showed active bleeding from the muscular branch of the right deep femoral artery, which was then successfully embolized.

키워드

참고문헌

  1. Hak DJ, Olson SA, Matta JM. Diagnosis and management of closed internal degloving injuries associated with pelvic and acetabular fractures: the Morel-Lavallee lesion. J Trauma 1997;42:1046-51. https://doi.org/10.1097/00005373-199706000-00010
  2. Parra JA, Fernandez MA, Encinas B, Rico M. Morel-Lavallee effusions in the thigh. Skeletal Radiol 1997;26:239-41. https://doi.org/10.1007/s002560050228
  3. Claassen L, Franssen MA, de Loos ER. A rare case of hemorrhagic shock: Morel-Lavallee lesion. Clin Pract Cases Emerg Med 2019;3:417-20. https://doi.org/10.5811/cpcem.2019.9.43674
  4. Hudson DA, Knottenbelt JD, Krige JE. Closed degloving injuries: results following conservative surgery. Plast Reconstr Surg 1992;89:853-5. https://doi.org/10.1097/00006534-199205000-00013
  5. Diviti S, Gupta N, Hooda K, Sharma K, Lo L. Morel-Lavallee lesions-review of pathophysiology, clinical findings, imaging findings and management. J Clin Diagn Res 2017;11:TE01-4.
  6. Opdam KTM, Coevering R van de, Haven I van der. Morel-Lavallee lesion: a not so rare, but often missed diagnosis. Open J Trauma 2017;1:64-5. https://doi.org/10.17352/ojt.000012
  7. Zhang BF, Cong YX, Wang PF, Huang H, Wang H, Zhuang Y. Deep femoral artery branch pseudoaneurysm formation and injury after hip fracture surgery: a case series and a literature review. Medicine (Baltimore) 2018;97:e9872. https://doi.org/10.1097/md.0000000000009872
  8. Potenza V, Saputo U, Catellani F, Farsetti P, Caterini R. Laceration of a branch of the profunda femoris artery caused by a spike of the displaced lesser trochanter in an inter-trochanteric femoral fracture. A case report. Int J Surg Case Rep 2016;24:195-8. https://doi.org/10.1016/j.ijscr.2016.05.048
  9. Mueller DK, Greenberg JJ, Marshall WJ, Maull KI. Rupture of the deep femoral artery from blunt trauma. J Trauma 1995;39:1010-1. https://doi.org/10.1097/00005373-199511000-00035
  10. Littlejohn L, Bennett BL, Drew B. Application of current hemorrhage control techniques for backcountry care: part two, hemostatic dressings and other adjuncts. Wilderness Environ Med 2015;26:246-54. https://doi.org/10.1016/j.wem.2014.08.018
  11. Nooh A, Wang CK, AlAseem A, Harvey EJ, Bernstein M. Acute thigh compartment syndrome due to an occult arterial injury following a blunt trauma: a case report. JBJS Case Connect 2020;10:e0506. https://doi.org/10.2106/jbjs.cc.18.00506
  12. Burghardt RD, Siebenlist S, Dobele S, Lucke M, Stockle U. Compartment syndrome of the thigh. A case report with delayed onset after stable pelvic ring fracture and chronic anticoagulation therapy. BMC Geriatr 2010;10:51. https://doi.org/10.1186/1471-2318-10-51
  13. Chen L, Reisner AT, Gribok A, Reifman J. Exploration of prehospital vital sign trends for the prediction of trauma outcomes. J Spec Oper Med 2010;10:55-62. https://doi.org/10.55460/3QLX-JDTT
  14. Singh R, Rymer B, Youssef B, Lim J. The Morel-Lavallee lesion and its management: a review of the literature. J Orthop 2018;15:917-21. https://doi.org/10.1016/j.jor.2018.08.032
  15. Nickerson TP, Zielinski MD, Jenkins DH, Schiller HJ. The Mayo Clinic experience with Morel-Lavallee lesions: establishment of a practice management guideline. J Trauma Acute Care Surg 2014;76:493-7. https://doi.org/10.1097/TA.0000000000000111