Thoracolumbar Morel-Lavallée Lesion as an Unusual Source of Post-Traumatic Anemia: A Case Report and Literature Review

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Abstract
Introduction:Morel-Lavallée lesions are rare closed degloving injuries resulting from traumatic shear forces that separate the subcutaneous tissue from the underlying fascia. Although they most frequently occur in the pelvis and thigh, thoracolumbar involvement is exceedingly uncommon and may be underrecognized in trauma settings, leading to delays in diagnosis.Case Report:A 22-year-old man was admitted following a motor-vehicle accident with left-sided pulmonary contusion and pneumothorax and was managed conservatively. On the second day of hospitalization, his hemoglobin level abruptly fell to 5 g/dL despite stable daily thoracic imaging. Subsequent cross-sectional studies revealed a 25-cm hematoma extending from the thoracolumbar region into the left gluteal and lateral thigh compartments, consistent with a Morel-Lavallée lesion. The patient was managed conservatively with compression and transfusion of four units of erythrocyte suspension, resulting in clinical stabilization and full recovery.Conclusion:Thoracolumbar Morel-Lavallée lesions are rare but may lead to substantial concealed blood loss. They should be considered in trauma patients presenting with unexplained anemia. Early imaging—CT for rapid assessment and MRI for definitive characterization—supports timely diagnosis, and carefully selected patients may achieve complete recovery with vigilant conservative management.

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