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J Korean Soc Emerg Med > Volume 30(5); 2019 > Article
Journal of The Korean Society of Emergency Medicine 2019;30(5): 468-472.
Hemorrhagic shock caused by closed internal degloving injury: a case report
Hyung-Bin Kim1, Soon-Chang Park1 , Sung-Hwa Lee1 , Byung-Kwan Bae1, Young-Mo Cho1 , Jae-Hoon Jang2, Sung-Wook Park1
1Department of Emergency Medicine, Pusan National University Hospital, Busan, Korea
2Department of Orthopedic Surgery, Pusan National University Hospital, Busan, Korea
Correspondence  Sung-Wook Park ,Tel: 051-240-7503, Fax: 051-253-6472, Email: psu52156@naver.com,
Received: February 22, 2019; Revised: May 17, 2019   Accepted: June 5, 2019.  Published online: October 31, 2019.
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.
Key words: Soft tissue injuries; Degloving injuries; Hemorrhagic shock; Hematoma; Contusion
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