PDF(Pubmed)
Abstract：
BACKGROUND First described in 1863 by French surgeon Victor-Auguste-François Morel-Lavallee, the Morel-Lavallee lesion (MLL) is a closed traumatic soft-tissue degloving injury. These lesions most commonly occur following motor vehicle collisions (MVCs). The pathophysiology stems from a shearing force that causes separation of the soft tissue from the fascia underneath, which disrupts the vasculature and lymphatic vessels that perforate between the tissue layers. Timely diagnosis and treatment are imperative, as a delayed diagnosis can lead to complications. However, at present there is no universally accepted treatment algorithm. CASE REPORT A 60-year-old morbidly obese woman presented after being involved in an MVC. She complained of abdominal tenderness in the right lower quadrant, with no evidence of peritonitis. Cross-sectional imaging revealed hemoperitoneum and a traumatic posterior abdominal wall/lumbar hernia on the right, with multiple contusions in the subcutaneous abdomen. The patient was taken to the operating room and underwent an exploratory laparotomy that revealed a large abdominal Morel-Lavallee lesion (MLL) along with a traumatic abdominal wall hernia (TAWH). There was also a mesenteric avulsion injury with an associated ileocecal injury. The patient underwent resection of the involved bowel, with primary anastomosis, debridement of the abdominal wall degloving injury, and expectant management for the hernia defect. She recovered from the injuries and was doing well when followed up in the clinic, with follow-up to repair the hernia in the near future. CONCLUSIONS More research is needed to provide surgeons with evidence-based standardized therapies for dealing with these rare pathologies to ensure optimal patient outcomes.
摘要：
背景技术法国外科医生Victor-Auguste-FrançoisMorel-Lavallee于1863年首次描述，Morel-Lavallee病变（MLL）是一种闭合性创伤性软组织脱套损伤。这些病变最常发生在机动车碰撞(MVCs)之后。病理生理学源于剪切力，导致软组织与下面的筋膜分离，破坏在组织层之间穿孔的脉管系统和淋巴管。及时诊断和治疗势在必行,因为延迟诊断会导致并发症。然而,目前还没有普遍接受的治疗算法。案例报告一名60岁的病态肥胖妇女在参与MVC后出现。她抱怨右下腹有压痛，没有腹膜炎的证据.横断面成像显示腹腔积血和右侧创伤性后腹壁/腰疝，皮下腹部多处挫伤.患者被带到手术室，并进行了剖腹探查，发现腹部大的Morel-Lavallee病变（MLL）以及创伤性腹壁疝（TAWH）。还有肠系膜撕脱伤和相关的回盲部损伤。患者接受了受累肠切除术，原发性吻合术，腹壁脱套伤清创术，以及对疝缺损的预期管理。她从受伤中恢复过来，在诊所进行随访时表现良好，在不久的将来进行后续手术以修复疝气。结论需要更多的研究来为外科医生提供基于证据的标准化疗法来处理这些罕见的病理，以确保最佳的患者预后。
