Liposuction Treatment of a Subacute Morel-Lavallée Lesion

A Case Report

Shana S. Kalaria, MD; Alexis Boson, BS; Lance W. Griffin, MD, FACS

Disclosures

Wounds. 2020;32(4):E23-E26. 

In This Article

Abstract and Introduction

Abstract

Introduction: A Morel-Lavallée lesion (MLL) is a rare and aesthetically concerning condition caused by a shearing force between subcutaneous fat and underlying fascia. Subsequent seroma formation occurs after the initial trauma of a crush injury, ligamentous sprain, or abdominal liposuction. Misdiagnosed lesions lead to inadequate treatment and are a source of chronic pain.

Case Report: The case of a 33-year-old woman who presented with a large, painful subacute MLL of the left thigh after being run over by a truck 3 weeks prior is reported. Physical examination revealed severe hyperesthesia and fluctuance of the left thigh. After confirmation of the fluid collection by X-ray and computed tomography angiogram, the authors performed liposuction of the cavity and seroma wall to evacuate and treat the lesion. Postoperative care consisted of a temporary drain, thigh compression, and oral antibiotics. Immediate reduction in size was appreciated intraoperatively with no reaccumulation of fluid at postoperative visits on week 1 and week 6. The pathology report confirmed seroma etiology, and all cultures of the fluid returned negative. At the end of her postoperative course, the patient reported a reduction in pain and no recurrence of her symptoms.

Conclusions: This case of MLL was diagnosed early and successfully treated with liposuction, resulting in an acceptable cosmetic outcome. It is the authors' hope that this case report will lead to earlier diagnosis and proper treatment of MLLs.

Introduction

A Morel-Lavallée lesion (MLL), first described by Maurice Morel-Lavallée in 1853, is a rare internal degloving injury as a result of traumatic shearing forces between the subcutaneous fat and underlying deep fascia.[1,2] These lesions are often seen after low-velocity crush injuries or high-velocity blunt force trauma.[2] Consequently, the disruption in blood supply and lymphatics in the fat allow a dead space seroma to develop.[2] If misdiagnosed, they become a source of chronic pain for patients.

The authors describe the case of a 33-year-old woman, who after being run over by a truck, presented with a subacute MLL that was successfully treated with liposuction. The authors present the case of an early diagnosis of a subacute MLL and definitive treatment with liposuction; it is their hope this case may provide insight into an area lacking in the literature.

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