Turkiye Klinikleri Journal of Forensic Medicine and Forensic Sciences

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Bir Künt Travmatik Lezyon Olarak Morel-Lavallee Lezyonu
Morel-Lavallee Lesion as a Blunt Traumatic Lesion
Melikşah Raşit DEMİRCANa, Kamil Hakan DOĞANa, Şerafettin DEMİRCİb
aSelçuk Üniversitesi Tıp Fakültesi, Adli Tıp ABD, Konya, TÜRKİYE
bNecmettin Erbakan Üniversitesi Meram Tıp Fakültesi, Adli Tıp ABD, Konya, TÜRKİYE
Turkiye Klinikleri J Foren Sci Leg Med. 2021;18(1):100-4
doi: 10.5336/forensic.2020-79012
Article Language: TR
Full Text
ÖZET
 Morel-Lavallee lezyonu (MLL), ilk olarak lezyona adını veren Fransız cerrah Victor-Auguste-François Morel-Lavallee tarafından tanımlanmıştır. Şiddetli bir künt travma sonrasında subkutanöz dokunun altındaki fasyadan sıyrılarak ayrılması (kapalı degloving) sonucu bir boşluk meydana gelir ve ortaya çıkan bu ölü boşlukta kan ve lenf birikimi görülür. Hastalar genellikle ağrı, şişlik ve sertlik şikâyetleriyle hastaneye başvurmaktadır. 2014 yılında iş makinesi operatörü olarak çalıştığı sırada kullandığı aracın arkasına geçtiğinde bir başka araç tarafından 2 araç arasında sıkıştırılan ve yaralanan şahsın olay tarihindeki ilk muayenesinde sol femurda şişlik ve hassasiyet olduğu, x-ray bulgularının olmadığı, 3 gün sonraki manyetik rezonans incelemesinde MLL ile uyumlu bulgular olduğu tespit edilmiştir. Şahsın, kazadan 4 yıl sonra tarafımızca yapılan muayenesinde sol uyluk orta kısmında hâlen MLL ile uyumlu muayene bulguları olduğu saptanmıştır. Bu olgu sunumunda amaç, travma sonrası ortaya çıkan bir yumuşak doku yaralanması niteliğinde olan lezyonun hem adli rapor hem de maluliyet değerlendirmesinde doğru şekilde ele alınması adına nadir görülen bu patolojik lezyonun bulgularını literatür bilgileri eşliğinde tartışarak adli tıp farkındalığını artırmaktır.

Anahtar Kelimeler: Morel-Lavallee lezyonu; künt travma; maluliyet
ABSTRACT
 The Morel-Lavallee lesion was first described by the French surgeon Victor-Auguste-François Morel-Lavallee. After a severe blunt trauma, a cavity is formed as a result of the detachment of the subcutaneous tissue from the fascia underneath (closed degloving), and blood and lymph accumulation is seen in this space. Patients generally apply to the hospital with complaints of pain, swelling and stiffness. A male patient who was working as a vehicle operator had an accident in 2014 when he moved behind the vehicle he was operating and got trapped and injured between 2 vehicles. Upon first medical examination he had swelling and tenderness in the left femur, there were no x-ray findings. Three days later, magnetic resonance examination of the left thigh was performed and findings compatible with the Morel-Lavallee lesion were detected. During the physical examination of the person performed in our polyclinic 4 years after the accident, we found there were physical examination findings compatible with Moral-Lavallee lesion. In this case report, the aim is to increase the awareness of forensic medicine experts by discussing the findings of this rare pathological lesion, which is a soft tissue injury occurring after trauma, both in the forensic reporting and in the evaluation of disability, in the light of the literature.

Keywords: Morel-Lavallee lesion; blunt trauma; disability
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