Closed internal degloving injury with conservative treatment

Hsing-Lin Lin; Wei-Che Lee; Liang-Chi Kuo; Chao-Wen Chen

doi:10.1016/j.ajem.2007.05.006

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Closed internal degloving injury with conservative treatment

Hsing-Lin Lin, MD

Wei-Che Lee, MD

Liang-Chi Kuo, MD

Chao-Wen Chen, MD

Department of Trauma Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung 807, Taiwan

DOI: http://dx.doi.org/10.1016/j.ajem.2007.05.006

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Fig. 1

The fluid tracks up around the gluteus maximus muscle and to the lumbosacral region (small arrow), with slight crossing of the midline to both sides (long arrow).

Fig. 2

Computed tomography of the pelvis shows the subcutaneous fluid collection (short arrow) extending from the region of the lumbosacral spine along the right lateral buttock to the thigh and down to the level of the femoral shaft, and a fracture is also found (long arrow).

Fig. 3

After 10 months of drainage, the fluid accumulation was totally resolved.

In the emergency department, we frequently manage patients with multiple contusions and bruise over the trunk without severe injuries. Emergency department discharge is a common option for these patients, and we may neglect the existence of closed internal degloving injury, which is a soft tissue injury with pelvic trauma, combining the subcutaneous tissue torn away from the underlying fascia followed by a cavity being filled with hematoma and liquefied fat created in the next few days (Harefuah 2006;145:111-3:66, J Trauma 1997;42:1046).

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Closed internal degloving injury with conservative treatment

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