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Title: Simultaneous occurrence of a severe Morel-Lavallée lesion and gluteal muscle necrosis as a sequela of transcatheter angiographic embolization following pelvic fracture: a case report.
Authors: Shimizu, Takayoshi  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-2683-0489 (unconfirmed)
Matsuda, Shuichi  kyouindb  KAKEN_id
Sakuragi, Atsushi
Tsukie, Tomio
Kawanabe, Keiichi
Author's alias: 松田, 秀一
Keywords: Fillet flap
Gluteal muscle necrosis
Hemipelvectomy
Morel-Lavallée lesion
Pelvic fracture
Sepsis
Transcatheter angiographic embolization
Issue Date: 26-Mar-2015
Publisher: BioMed Central Ltd.
Journal title: Journal of medical case reports
Volume: 9
Thesis number: 69
Abstract: [Introduction] Morel-Lavallée lesions are posttraumatic hemolymphatic collections caused by disruption of the interfascial planes between the subcutaneous soft tissue and muscle. Severe peripelvic Morel-Lavallée lesions have rarely been reported in the literature. By contrast, a number of cases of gluteal muscle necrosis following transcatheter angiographic embolization for pelvic fracture have been reported. Each entity can result in severe infection and sepsis, and the mortality rate in such cases is quite high. However, to date, no previous reports have described a case in which these life-threatening entities occurred simultaneously. [Case presentation] A 32-year-old Asian man simultaneously developed severe peripelvic Morel-Lavallée lesions and gluteal muscle necrosis with sepsis following transcatheter angiographic embolization after an unstable pelvic fracture. Extremely large skin and soft tissue defects, which were untreatable with any commonly used flaps, were generated after repeated debridement. In addition, a deep-bone infection was suspected in his left fractured iliac bone, while motor function was almost completely lost in his left leg, possibly as a sequela of transcatheter angiographic embolization. As a result of his condition, a left hemipelvectomy was unavoidable. A pedicled fillet flap from his sacrificed left limb was used for the treatment of the defects and to provide a durable base for a prosthesis. Our patient survived and returned to his previous job 24 months after the surgery wearing a prosthetic left leg. [Conclusion] As illustrated by the present case, severe peripelvic Morel-Lavallée lesions and gluteal muscle necrosis following transcatheter angiographic embolization can occur simultaneously after unstable pelvic fractures. Physicians should recognize that these entities can result in life-threatening sepsis and, therefore, should attempt to detect them as early as possible. When hemipelvectomy is unavoidable, a pedicled upper and lower leg in-continuity fillet flap may provide satisfactory outcomes.
Rights: © Shimizu et al.; licensee BioMed Central. 2015
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
URI: http://hdl.handle.net/2433/214475
DOI(Published Version): 10.1186/s13256-015-0550-7
PubMed ID: 25890103
Appears in Collections:Journal Articles

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