Morel-Lavallée lesion in a 12-month-old child: A case report and literature review

INTRODUCTION: The Morel-Lavallée lesion is an infrequently described, post-traumatic closed de-gloving wound that results from separation of the skin and subcutaneous tissues from the underlying deep fascia as a result of shearing forces that tear perforating vessels and lymphatics. This condition is rare in children and to our knowledge it represents the youngest case of Morel-Lavallée lesion yet reported. PRESENTATION OF CASE: We report on a twelve-month-old girl who presented after a motor vehicle accident with a tender fluctuant mass of the back and buttocks. Computed tomography revealed a large but discrete fluid collection between the subcutaneous fat and the deep fascial planes, extending from the posterior thoracic paraspinal soft tissues to the right gluteal region. A diagnosis of Morel-Lavallée lesion was made. This patient was managed with serial ultrasound-guided percutaneous drainage and compression bandages. The patient did well and was subsequently discharged. There was no recurrence of the lesion on follow-up. DISCUSSION: The Morel-Lavallée lesion is a rare consequence of abrupt high impact trauma. There is no accepted management approach and a variety of conservative as well as surgical options exist. Goals of management include drainage, debridement and meticulous dead space management to prevent recurrence. CONCLUSION: The Morel-Lavallée lesion is a rare finding in children involved in high impact trauma and prompt intervention is crucial to prevent complications. Image-guided drainage is a rational management approach with excellent outcomes.