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Hemorrhagic shock caused by closed internal degloving injury: a case report

대한응급의학회지 2019년 30권 5호 p.468 ~ 472
 ( Kim Hyung-Bin ) - Pusan National University Hospital Department of Emergency Medicine

 ( Park Soon-Chang ) - Pusan National University Hospital Department of Emergency Medicine
 ( Lee Sung-Hwa ) - Pusan National University Hospital Department of Emergency Medicine
 ( Bae Byung-Kwan ) - Pusan National University Hospital Department of Emergency Medicine
 ( Cho Young-Mo ) - Pusan National University Hospital Department of Emergency Medicine
 ( Jang Jae-Hoon ) - Pusan National University Hospital Department of Orthopaedic Surgery
 ( Park Sung-Wook ) - Pusan National University Hospital Department of Emergency Medicine

Abstract


A closed internal degloving injury is a soft tissue injury, in which the subcutaneous tissue is ripped from the underlying fascia. In rare cases, a closed internal degloving injury can lead to hemorrhagic shock. A 79-year-old woman was brought to the emergency department following an auto-pedestrian accident, in which she was hit by a car. She was in a stupor and was hypotensive. The initial evaluation was unremarkable. During management, the patient required the transfusion of a large volume of blood, and vasoactive agent. Abdominal computed tomography revealed a large hematoma in her lower back and gluteal area and she was diagnosed with a closed internal degloving injury. Missed or delayed diagnosis of this type of injury may result in a significant increase in transfusion requirements and irreversible hemorrhagic shock.

키워드

Soft tissue injuries; Degloving injuries; Hemorrhagic shock; Hematoma; Contusion
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