The CT-scan is very useful in the initial care of stable patients with gunshot wounds as regards the haemodynamics and helps objectify the path of the bullet and obtain a precise assessment of the damage. Conventional x-rays are unavoidable for wounds to the legs and spine.
Introduction
Morel-Lavallée syndrome (MLS) is considered as a rare entity and hemorrhagic shock as a complication is uncommon.
Presentation of case
We report the case of a 56-year- old man who presented to the emergency department after a road traffic accident. Initially, the patient was hemodynamically unstable (heart rate 160 beats/min and blood pressure 65/30). Physical examination revealed multiple lacerations on his back and a gradually expanding large subcutaneous hematoma on the left flank extending to the hip and left leg. Fluid resuscitation was rapidly initiated. After stabilizing his hemodynamic status, a full-body computed tomography was performed revealing, apart from a small unilateral pneumothorax and a stable pelvis fracture, an extensive Morel-Lavallée lesion in the lumbar region extending to the hip and both legs. The patient was then transferred to a surgical intensive care unit for further resuscitation and surgical drainage of the collection followed by continuous suction was performed. Even though rare, Hemorrhagic shock is one of the threatening complications of Morel-Lavallée lesions and should be kept in mind by every traumatologist and emergency doctor.
Conclusion
We report a case about a rare complication of MLS which is hemorrhagic shock in order to highlight the importance of making the diagnosis, which can be unrecognized, and initiate an adequate treatment on time.
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