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Retrosacral Morel-Lavallée lesion: resolution with ultrasound-guided drainage and sclerotherapy

Morel-Lavallée lesions are chronic seromas due to closed degloving injuries, resulting from blunt trauma. They most commonly occur over the greater trochanteric, gluteal and flank regions. We present a case of retrosacral Morel-Lavallée lesion. Initial ultrasound demonstrated a fluid collection lyin...

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Detalles Bibliográficos
Autores principales: Leach, Samuel Edward Thomas, Wotherspoon, Mark, King, Leonard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The British Institute of Radiology. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7465740/
https://www.ncbi.nlm.nih.gov/pubmed/32922835
http://dx.doi.org/10.1259/bjrcr.20190120
Descripción
Sumario:Morel-Lavallée lesions are chronic seromas due to closed degloving injuries, resulting from blunt trauma. They most commonly occur over the greater trochanteric, gluteal and flank regions. We present a case of retrosacral Morel-Lavallée lesion. Initial ultrasound demonstrated a fluid collection lying between the subcutaneous fat and the underlying fascia superficial to the sacrum. Following repeated ultrasound-guided aspirations, further recurrence of a superficial pre-sacral seroma was confirmed with MRI. Ultrasound-guided aspiration was performed and 100 mg of injectable doxycycline was instilled into the lesion. 4 months after sclerotherapy, the patient was asymptomatic, and follow-up MRI demonstrated no residual fluid collection or complication. This case demonstrates the value of using MRI in conjunction with ultrasound to characterize Morel-Lavallée lesions in an atypical site and in confirming response to treatment, in addition to the use of sclerotherapy for treatment of a lesion refractory to repeated aspiration.