Morel-Lavallee Lesion of the Lower Back Mimicking an Abscess: A Case Report

Abstract

A closed degloving injury, or Morel-Lavallee lesion, is the result of a severe, traumatic, shearing injury, causing separation of the skin and subcutaneous tissue from the underlying deep fascia. Though well described in the orthopedic trauma literature, this lesion is not well recognized by the general surgeon in the poly-trauma setting. We present a case of a 41 year old man who was referred to the general surgery service for a “back abscess”. Upon patient interview, history of a recent motor vehicle collision (MVC) was obtained, including a pelvic fracture. Imaging demonstrated a large Morel-Lavellee lesion extending from the pelvis into the lower back. Knowledge of this entity is crucial to avoid unnecessary procedures in the management of these patients.

Share and Cite:

S. de Montbrun, K. Khalili, S. MacLellan and A. Easson, "Morel-Lavallee Lesion of the Lower Back Mimicking an Abscess: A Case Report," Surgical Science, Vol. 3 No. 4, 2012, pp. 213-215. doi: 10.4236/ss.2012.34041.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Morel-Lavallee, “Decollements Traumatique de la Peau et des Couches Sous-Jacented,” Archives of General Medicine, Vol. 1, 1863, pp. 20-38.
[2] T. J. Phillips, B. Jeffcote and D. Collopy, “Bilateral Morel-Lavallée Lesions after Complex Pelvic Trauma: A Case Report,” The Journal of Trauma, Vol. 65, No. 3, 2008, pp. 708-711. doi:10.1097/TA.0b013e31815eb74b
[3] D. J. Hak, S. A. Olson and J. M. Matta, “Diagnosis and Management of Closed Internal Degloving Injuries Associated with Pelvic and Acetabular Fractures: The Morel-Lavallée lesion,” The Journal of Trauma, Vol. 42, No. 6, 1997, pp. 1046-1051. doi:10.1097/00005373-199706000-00010
[4] R. N. Reddix, E. Carroll and L. X. Webb, “Early Diagnosis of a Morel-Lavallee Lesion Using Three-Dimensional Computed Tomography Reconstructions: A Case Report,” The Journal of Trauma, Vol. 67, 2009, pp. E57-E59. doi:10.1097/TA.0b013e31814b2d20
[5] M. Tile, D. Helfet and J. Kellam, “Fractures of the Pelvis and Acetabulum,” 3rd Edition, Lippincott, Williams & Wilkins, Philadelphia, 2003.
[6] S. Tseng and P.Tornetta III, “Percutaneous Management of Morel-Lavallee Lesions,” The Journal of Bone and Joint Surgery. American Volume, Vol. 88, No. 1, 2006, pp. 92-96. doi:10.2106/JBJS.E.00021
[7] H. L. Lin, W. C. Lee, L. C. Kuo and C. W. Chen, “Closed Internal Degloving Injury with Conservative Treatment,” The American Journal of Emergency Medicine, Vol. 26, 2008, pp. 254.e5-6.
[8] C. Neal, J. A. Jacobson, C. Brandon, M. Kalume-Brigido, Y. Morag and G. Girish, “Sonography of Morel-Lavallee Lesions,” Journal of Ultrasound in Medicine, Vol. 27, No. 7, 2008, pp. 1077-1081.
[9] J. M. Mellado, L. Pérez del Palomar, L. Díaz, A. Ramos and A. Saurí, “Long-Standing Morel-Lavallée Lesions of the Trochanteric Region and Proximal Thigh: MRI Features in Five Patients,” American Journal of Roentgenology, Vol. 182, No. 5, 2004, pp. 1289-1294.
[10] S. A. Kottmeier, S. C. Wilson, C. T. Born, G. A. Hanks, W. M. Iannacone and W. G. De Long, “Surgical Management of Soft Tissue Lesions Associated with Pelvic Ring Injury,” Clinical Orthopaedics and Related Research, Vol. 329, 1996, pp. 46-53. doi:10.1097/00003086-199608000-00007

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.