{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T23:24:29Z","timestamp":1782861869309,"version":"3.54.5"},"reference-count":17,"publisher":"California Digital Library (CDL)","issue":"4","license":[{"start":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T00:00:00Z","timestamp":1571616000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Hemorrhage is a major cause of death among trauma patients. Controlling the bleeding is essential but can be difficult when the source of bleeding remains unidentified. We present a 67-year-old healthy male with a hypovolemic shock after a suicide attempt by jumping from a height. Apart from a bilateral pneumothorax with multiple rib fractures, a femur fracture and spine fractures, computer tomography (CT) revealed a closed, degloving injury of the back, also known as a Morel-Lavall\u00e9e lesion. Hemodynamic instability due to hemorrhage caused by a Morel-Lavall\u00e9e lesion in the lumbar region is very rare and easily overlooked. This case demonstrates the importance of clinical signs of Morel-Lavall\u00e9e, and illustrates the need for total body CTs to exclude other locations of bleeding and to detect contrast extravasation. This report also discusses the possible treatment options for Morel-Lavall\u00e9e lesions.<\/jats:p>","DOI":"10.5811\/cpcem.2019.9.43674","type":"journal-article","created":{"date-parts":[[2019,11,5]],"date-time":"2019-11-05T17:54:14Z","timestamp":1572976454000},"page":"417-420","source":"Crossref","is-referenced-by-count":10,"title":["A Rare Case of Hemorrhagic Shock: Morel-Lavall\u00e9e Lesion"],"prefix":"10.5811","volume":"3","author":[{"given":"Lieke","family":"Claassen","sequence":"first","affiliation":[{"name":"Zuyderland Medical Centre, Department of Emergency Medicine, Heerlen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myriam","family":"Franssen","sequence":"additional","affiliation":[{"name":"Zuyderland Medical Centre, Department of Emergency Medicine, Heerlen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Robert de Loos","sequence":"additional","affiliation":[{"name":"Zuyderland Medical Centre, Department of Surgery, Heerlen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"29705","published-online":{"date-parts":[[2019,10,21]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Krug EG, Sharma GK, Lozano R. Global burden of injuries. Am J Public Health. 2000;90(4):523-6.","DOI":"10.2105\/AJPH.90.4.523"},{"key":"ref1","unstructured":"Morel-Lavall\u00e9e M. Decollements traumatiques de la peau et des couches sous jacentes [French]. Arch Gen Med. 1863;1:172-200."},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Zairi F, Wang Z, Shedid D, et al.\u00a0Lumbar Morel-Lavall\u00e9e lesion: case report and review of the literature. Orthop Traumatol Surg Res. 2016;102(4):525-7.","DOI":"10.1016\/j.otsr.2016.01.006"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Anakwenze OA, Trivedi V, Goodman AM, et al. Concealed degloving injury (the Morel-Lavall\u00e9e lesion) in childhood sports: a case report. J Bone Joint Surg Am. 2011;93(24):e148.","DOI":"10.2106\/jbjs.k.00219"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Hefny AF, Kaka LN, Salim El NA, et al. Unusual case of life threatening subcutaneous hemorrhage in a blunt trauma patient. Int J Surg Case Rep. 2015;15:119-22.","DOI":"10.1016\/j.ijscr.2015.08.035"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Yumoto T, Sato K, Ugawa T, et al. An unusual case of a patient who presented with haemorrhagic shock following massive subcutaneous haematomas of the lower back due to blunt trauma. BMJ Case Rep. 2015;2015:bcr2015211645.","DOI":"10.1136\/bcr-2015-211645"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Mao RD, Tan EP, Goh HK. An unusual cause of haemorrhagic shock from a subcutaneous haematoma: a Morel-Lavall\u00e9e lesion. Singapore Med J. 2015 Apr;56(4):e62-4.","DOI":"10.11622\/smedj.2015063"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Hudson DA, Knottenbelt JD, Krige JE. Closed degloving injuries: results following conservative surgery. Plast Reconstr Surg. 1992;89(5):853-5.","DOI":"10.1097\/00006534-199205000-00013"},{"key":"ref8","unstructured":"Van Vugt JLA, Beks SBJC, Borghans RAP, et al. The Morel-Lavall\u00e9e-lesion: delayed symptoms after trauma [Dutch]. Ned Tijdschr Geneeskd. 2013;157(23):A5914."},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"McKenzie GA, Niederhauser BD, Collins MS, et al. CT characteristics of Morel-Lavall\u00e9e lesions: an underrecognized but significant finding in acute trauma imaging. Skeletal Radio. 2016;45(8):1053-60.","DOI":"10.1007\/s00256-016-2374-y"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Goodman BS, Smith MT, Mallempati S, et al. A comparison of ultrasound and magnetic resonance imaging findings of a Morel-Lavall\u00e9e lesion of the knee. PM R. 2013;5(1):70-3.","DOI":"10.1016\/j.pmrj.2012.08.001"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Vanhegan IS, Dala-Ali B, Verhelst L, et al. The Morel-Lavallee lesion as a rare differential diagnosis for recalcitrant bursitis of the knee: case report and literature review. Case Rep Orthop. 2012;2012:593193.","DOI":"10.1155\/2012\/593193"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Bonilla-Yoon I, Masih S, Patel DB, et al. The Morel-Lavall\u00e9e lesion: pathophysiology, clinical presentation, imaging features, and treatment options. Emerg Radiol. 2014;21(1):35-43.","DOI":"10.1007\/s10140-013-1151-7"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Moriarty JM, Borrero CG, Kavanagh EC. A rare cause of calf swelling: the Morel-Lavallee lesion. Ir J Med Sci. 2011;180(1):265-8.","DOI":"10.1007\/s11845-009-0386-5"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Bansal A, Bhatia N, Singh A, et al. Doxycycline sclerodesis as a treatment option for persistent Morel-Lavall\u00e9e lesions. Injury. 2013;44(1):66-9.","DOI":"10.1016\/j.injury.2011.11.024"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Shen C, Peng JP, Chen XD. Efficacy of treatment in peri-pelvic Morel-Lavallee lesion: a systematic review of the literature. Arch Orthop Trauma Surg. 2013;133(5):635-40.","DOI":"10.1007\/s00402-013-1703-z"},{"key":"ref16","unstructured":"American College of Surgeons Committee on Trauma. (2008). Advanced Trauma Life Support Student Course. 8th ed. Chicago, IL: American College of Surgeons."}],"container-title":["Clinical Practice and Cases in Emergency Medicine"],"original-title":[],"deposited":{"date-parts":[[2019,11,7]],"date-time":"2019-11-07T19:01:47Z","timestamp":1573153307000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/4903g27m"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,21]]},"references-count":17,"issue-title":["Clinical Practice and Cases in Emergency Medicine"],"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,10,31]]}},"URL":"https:\/\/doi.org\/10.5811\/cpcem.2019.9.43674","relation":{},"ISSN":["2474-252X","2474-252X"],"issn-type":[{"value":"2474-252X","type":"electronic"},{"value":"2474-252X","type":"print"}],"subject":[],"published":{"date-parts":[[2019,10,21]]}}}