Morel-Lavallée lesion: Difference between revisions
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*Results in subcutaneous fluid collection after abrupt separation of skin and subcutaneous tissues from underlying fascia | *Results in subcutaneous fluid collection after abrupt separation of skin and subcutaneous tissues from underlying fascia | ||
**Disrupts capillaries and lymphatics resulting in leakage of lymph, blood, and necrotic fat | **Disrupts capillaries and lymphatics resulting in leakage of lymph, blood, and necrotic fat | ||
*Most commonly seen in proximal thigh | *Most commonly seen in proximal thigh or overlying hip | ||
**Also reported in trunk, prepatellar region, lumbar region, or scapular regions | **Also reported in trunk, prepatellar region, lumbar region, or scapular regions | ||
*If not diagnosed early, can become infected | *If not diagnosed early, can become infected | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
*[[ | *Hematoma | ||
*Tumor | |||
*[[Abscess]] | |||
*[[Deep venous thrombosis]] | *[[Deep venous thrombosis]] | ||
*[[Compartment syndrome]] | *[[Compartment syndrome]] | ||
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==Evaluation== | ==Evaluation== | ||
*Evaluate for tenderness, fluctuance | |||
*Labs | |||
**CBC- can have significant bleeding into the lesion, watch Hb | |||
*Imaging | |||
**MRI is modality of choice for evaluation, but these lesions are also visible on CT | |||
**Ultrasound can show a fluid collection, but can't be used to rule out | |||
==Management== | ==Management== | ||
Revision as of 19:14, 14 March 2018
Background
- Posttraumatic, closed degloving injury
- Results in subcutaneous fluid collection after abrupt separation of skin and subcutaneous tissues from underlying fascia
- Disrupts capillaries and lymphatics resulting in leakage of lymph, blood, and necrotic fat
- Most commonly seen in proximal thigh or overlying hip
- Also reported in trunk, prepatellar region, lumbar region, or scapular regions
- If not diagnosed early, can become infected
Clinical Features
- Enlarging, painful area of swelling
- Soft tissue fluctuance
- Associated with blunt trauma with or without associated fracture
Differential Diagnosis
- Hematoma
- Tumor
- Abscess
- Deep venous thrombosis
- Compartment syndrome
- Septic joint
- Necrotizing fasciitis
Extremity trauma
- Compartment syndrome
- Contusion
- Crush syndrome
- Degloving injury
- Fracture
- Laceration
- Myositis ossificans
- Open joint injury
- Peripheral nerve injury
- Rhabdomyolysis
- Tendon injury
- Vascular injury
Evaluation
- Evaluate for tenderness, fluctuance
- Labs
- CBC- can have significant bleeding into the lesion, watch Hb
- Imaging
- MRI is modality of choice for evaluation, but these lesions are also visible on CT
- Ultrasound can show a fluid collection, but can't be used to rule out
Management
- Will require surgical consultation and drainage
Disposition
- Admit
See Also
External Links
References
- ↑ J Emerg Med. 2015 Jul;49(1):e1-4. doi: 10.1016/j.jemermed.2014.12.084. Epub 2015 Apr 2.
- ↑ Nair AV, Nazar P, Sekhar R, Ramachandran P, Moorthy S. Morel-Lavallée lesion: A closed degloving injury that requires real attention. The Indian Journal of Radiology & Imaging. 2014;24(3):288-290. doi:10.4103/0971-3026.137053.