Morel-Lavallée lesion

Background

  • Posttraumatic, closed degloving injury[1]
  • Results in subcutaneous fluid collection after abrupt separation of skin and subcutaneous tissues from underlying fascia[2]
    • 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 high-energy, blunt trauma with or without associated fracture

Differential Diagnosis

Extremity trauma

Skin and Soft Tissue Infection

Look-A-Likes

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

References

  1. 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.
  2. J Emerg Med. 2015 Jul;49(1):e1-4. doi: 10.1016/j.jemermed.2014.12.084. Epub 2015 Apr 2.
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