J Korean Soc Emerg Med.
2019 Oct;30(5):468-472. 10.0000/jksem.2019.30.5.468.
Hemorrhagic shock caused by closed internal degloving injury: a case report
- Affiliations
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- 1Department of Emergency Medicine, Pusan National University Hospital, Busan, Korea. psu52156@naver.com
- 2Department of Orthopedic Surgery, Pusan National University Hospital, Busan, Korea.
- KMID: 2470567
- DOI: http://doi.org/10.0000/jksem.2019.30.5.468
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.
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