Olgu Sunumu
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Morel-Lavallee Lezyonunun Adli Travmatolojik Değerlendirilmesi: Bir Olgu Sunumu

Yıl 2022, Cilt: 44 Sayı: 4, 587 - 592, 19.07.2022

Öz

Morel-Lavallee lezyonu, travma sonrası subkutan dokunun altındaki fasyadan ayrıldığı bir yumuşak doku yaralanmasıdır. Kapalı degloving yaralanmaları nadir görülmekle birlikte birden fazla cerrahi müdahale gerektiren komplikasyonlara neden olabilmektedir. Morel-Lavalle yaralanmaları hastanın yaşam kalitesini etkileyen ağrı, hassasiyet ve şişlik gibi kronik semptomlara yol açabilmektedir. 2019 yılında üzerinden kamyon geçen 54 yaşında erkek olgunun olay tarihli muayenesinde lomber bölgede ve sağ femurda hassasiyet, sağ femurda hematom ve çap artışı olduğu görülmüştür. Olay tarihinden 3 gün sonra yapılan muayenesinde sağ lomber bölgeden dize kadar ve sol glutea distaline kadar cilt altı sıvı birikimi olduğu tespit edilmiş ve insizyonla aspire edilmiştir. Maluliyet değerlendirilmesi amacıyla 2020 yılında polikliniğe başvuran olgunun bilateral uylukta şişlik, ağrı ve yürürken aksama şikayetleri olduğu, yapılan muayenesinde kaza ile illiyetli olduğu değerlendirilen sekel değişiklikler saptanmış ve ilgili yönetmelik hükümleri kapsamında engel oranı belirlenmiştir. Adli tıp pratiğinde nadir karşılaşılabilecek bu tür bir olgunun literatür eşliğinde tartışılmasının adli tıp uygulamalarına katkı sağlayacağı düşünülmektedir.

Teşekkür

Makalenin eleştirel incelenmesinde fikirleriyle destek veren Uzm. Dr. Harun Akkaya’ya teşekkür ederiz.

Kaynakça

  • Singh R, Rymer B, Youssef B, Lim J. The Morel-Lavallée lesion and its management: A review of the literature. J Orthop. 2018;15(4):917-21. doi:10.1016/j.jor.2018.08.032.
  • Gummalla KM, George M, Dutta R. Morel-Lavallee lesion: Case report of a rare extensive degloving soft tissue injury. Ulus Travma Acil Cerrahi Derg. 2014;20(1):63-5. doi:10.5505/tjtes.2014.88403.
  • Labied M, Salam S, Jabri S, Laoudiyi D, Chbani K, Ouzidane L. Morel-Lavallee Syndrome: A rare tumefactive lesion. European Journal of Case Reports in Internal Medicine. 2020;7(12). doi:10.12890/2020_001910.
  • Nickerson T, Zielinski M, Jenkins D, Schiller H. The Mayo Clinic experience with Morel-Lavallée lesions: Establishment of a practice management guideline. J Trauma Acute Care Surg. 2014;76(2):493-7. doi:10.1097/TA.0000000000000111.
  • Tejwani S, Cohen S, Bradley J. Management of Morel-Lavallee lesion of the knee: Twenty-seven cases in the national football league. Am J Sports Med. 2007;35(7):1162-7. doi:10.1177/0363546507299448.
  • Zecha P, Missotten F. Pseudocyst formation after abdominoplasty-extravasations of Morel-Lavallée. Br J Plast Surg. 1999;52(6):500-2. doi:10.1054/bjps.1999.3154.
  • Hussein K, White B, Sampson M, Gupta S. Pictorial review of Morel-Lavallée lesions. J Med Imaging Radiat Oncol 2019 Apr;63(2):212-5. doi:10.1111/1754-9485.12854.
  • Kaya A. Goksen ME, Ata U, Aktas EO. The importance of morel-lavallee lesion in medicolegal evaluation: A case report. Medicine Science. 2017;6(3):582-4. doi:10.5455/medscience.2017.06.8626.
  • Porter D, Conley J, Ashurst J. Morel-Lavallée lesion following a low-speed injury: A case report. Clin Pract Cases Emerg Med. 2020 Nov;4(4):642-4. doi:10.5811/cpcem.2020.7.48358.
  • Dodwad S, Niedermeier S, Yu E, Ferguson T, Klineberg, Khan S. The Morel-Lavallée lesion revisited: management in spinopelvic dissociation. Spine J. 2015;15(6):45-51. doi:10.1016/j.spinee.2013.08.023.
  • Cruz N, Jiménez R. Morel-Lavallée lesion diagnosed 25 years after blunt trauma. International Journal of Surgery Case Reports 81 (2021) 105733. https://doi.org/10.1016/j.ijscr.2021.105733.
  • Volavc TS, Rupreht M. MRI of the Morel-Lavallée lesion-a case series. Radiol Oncol 2021;55(3):268-73. doi:10.2478/raon-2021-0018.
  • Muneer M, El-Menyar A, Abdelrahman H, Murad MA, Al Harami SM, Mokhtar A, et al. Clinical Presentation and Management of Pelvic Morel-Lavallee Injury in Obese Patients. J Emerg Trauma Shock. 2019 Jan-Mar;12(1):40-7. doi:10.4103/JETS.JETS_37_18.
  • Demircan MR, Doğan KH, Demirci Ş. Bir künt travmatik lezyon olarak Morel-Lavallee lezyonu. Turkiye Klinikleri J Foren Sci Leg Med. 2021;18(1):100-4. doi:10.5336/forensic.2020-79012.
  • Garbioğlu A. Evaluation of conflicts and manner of approach diversties among impairment reports of Forensic Medicine General Assembly of Council of Forensic Medicine of Turkey (dissertation). The Council of Forensic Medicine, Istanbul, 2018.

Forensic Traumatological Evaluation of Morel-Lavallee Lesion: A Case Report

Yıl 2022, Cilt: 44 Sayı: 4, 587 - 592, 19.07.2022

Öz

Morel Lavallee lesion is a post-traumatic soft tissue injury that subcutaneous tissue to seperate from the underlying fascia. Although closed degloving injuries are uncommon, they can cause complications requiring multiple surgical interventions. These injuries can lead to chronic symptoms, such as pain, sensibility and swelling, affecting the patient’s quality of life. In the even date examination of a 54-year-old male who was run over by a truck in 2019, it was observed that there was tenderness in the lumbar region and right femur, hematoma and an increase in diameter in the right femur. In the examination performed 3 days after the traffic accident, it was determined that there was a subcutaneous fluid accumulation from the right lumbar region to the knee and up to the distal left glutea, and it was aspirated with an incision. The case who applied to the outpatient clinic in 2020 for disability evaluation had complaints of swelling in both thighs, pain and limpness in walking, sequelae changes that were considered to be related to the accident were determined in the examination, and his disability rate was performed within the context of relevant guideline. It is thought that discussing such a rare case in forensic medicine practice in the light of literature will contribute to forensic medicine practices.

Kaynakça

  • Singh R, Rymer B, Youssef B, Lim J. The Morel-Lavallée lesion and its management: A review of the literature. J Orthop. 2018;15(4):917-21. doi:10.1016/j.jor.2018.08.032.
  • Gummalla KM, George M, Dutta R. Morel-Lavallee lesion: Case report of a rare extensive degloving soft tissue injury. Ulus Travma Acil Cerrahi Derg. 2014;20(1):63-5. doi:10.5505/tjtes.2014.88403.
  • Labied M, Salam S, Jabri S, Laoudiyi D, Chbani K, Ouzidane L. Morel-Lavallee Syndrome: A rare tumefactive lesion. European Journal of Case Reports in Internal Medicine. 2020;7(12). doi:10.12890/2020_001910.
  • Nickerson T, Zielinski M, Jenkins D, Schiller H. The Mayo Clinic experience with Morel-Lavallée lesions: Establishment of a practice management guideline. J Trauma Acute Care Surg. 2014;76(2):493-7. doi:10.1097/TA.0000000000000111.
  • Tejwani S, Cohen S, Bradley J. Management of Morel-Lavallee lesion of the knee: Twenty-seven cases in the national football league. Am J Sports Med. 2007;35(7):1162-7. doi:10.1177/0363546507299448.
  • Zecha P, Missotten F. Pseudocyst formation after abdominoplasty-extravasations of Morel-Lavallée. Br J Plast Surg. 1999;52(6):500-2. doi:10.1054/bjps.1999.3154.
  • Hussein K, White B, Sampson M, Gupta S. Pictorial review of Morel-Lavallée lesions. J Med Imaging Radiat Oncol 2019 Apr;63(2):212-5. doi:10.1111/1754-9485.12854.
  • Kaya A. Goksen ME, Ata U, Aktas EO. The importance of morel-lavallee lesion in medicolegal evaluation: A case report. Medicine Science. 2017;6(3):582-4. doi:10.5455/medscience.2017.06.8626.
  • Porter D, Conley J, Ashurst J. Morel-Lavallée lesion following a low-speed injury: A case report. Clin Pract Cases Emerg Med. 2020 Nov;4(4):642-4. doi:10.5811/cpcem.2020.7.48358.
  • Dodwad S, Niedermeier S, Yu E, Ferguson T, Klineberg, Khan S. The Morel-Lavallée lesion revisited: management in spinopelvic dissociation. Spine J. 2015;15(6):45-51. doi:10.1016/j.spinee.2013.08.023.
  • Cruz N, Jiménez R. Morel-Lavallée lesion diagnosed 25 years after blunt trauma. International Journal of Surgery Case Reports 81 (2021) 105733. https://doi.org/10.1016/j.ijscr.2021.105733.
  • Volavc TS, Rupreht M. MRI of the Morel-Lavallée lesion-a case series. Radiol Oncol 2021;55(3):268-73. doi:10.2478/raon-2021-0018.
  • Muneer M, El-Menyar A, Abdelrahman H, Murad MA, Al Harami SM, Mokhtar A, et al. Clinical Presentation and Management of Pelvic Morel-Lavallee Injury in Obese Patients. J Emerg Trauma Shock. 2019 Jan-Mar;12(1):40-7. doi:10.4103/JETS.JETS_37_18.
  • Demircan MR, Doğan KH, Demirci Ş. Bir künt travmatik lezyon olarak Morel-Lavallee lezyonu. Turkiye Klinikleri J Foren Sci Leg Med. 2021;18(1):100-4. doi:10.5336/forensic.2020-79012.
  • Garbioğlu A. Evaluation of conflicts and manner of approach diversties among impairment reports of Forensic Medicine General Assembly of Council of Forensic Medicine of Turkey (dissertation). The Council of Forensic Medicine, Istanbul, 2018.
Toplam 15 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm OLGU SUNUMLARI / CASE REPORTS
Yazarlar

Arif Garbioğlu 0000-0002-0440-0963

Tuğrul Kılıboz 0000-0003-3164-2316

Beycan Doğan 0000-0001-7389-8323

Kenan Karbeyaz 0000-0001-6009-0739

Yayımlanma Tarihi 19 Temmuz 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 44 Sayı: 4

Kaynak Göster

Vancouver Garbioğlu A, Kılıboz T, Doğan B, Karbeyaz K. Morel-Lavallee Lezyonunun Adli Travmatolojik Değerlendirilmesi: Bir Olgu Sunumu. Osmangazi Tıp Dergisi. 2022;44(4):587-92.


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