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Background and Aims Morel-Lavallée lesion is a closed degloving injury associated with high energy trauma. The skin and subcutaneous tissue are forcibly separated from the underlying fascia, creating a potential space filled with hemolymphatic fluid. We present a case of a 42-year-old, ASA II, female patient, victim of incarceration after a motor vehicle collision with immediate bilateral above the knee amputation, thoracic and pelvic trauma.

Methods On the 10th day after ICU admission an epidural catheter (EPC) was placed at L3-L4 level, by midline approach, using a loss of resistance to air technique with a 16G Tuohy needle and negative aspiration.

Results Following patient repositioning, it was noticed a pericatheter fluid leakage and 5 ml of saline were administered without an increase in drainage. It was decided to delay the start of the EPC infusion. Throughout the day, there was a continuous abundant drainage of liquid. A CT scan was performed to rule out cerebrospinal fluid-cutaneous fistula. Because the imaging test was unremarkable, Morel-Lavallée lesion was suspected and an MRI was ordered to confirm the diagnosis. The MRI did not show any collection of fluid, but since the scan was performed 3 days after the initial presentation it is possible that the lesion was already drained. The EPC infusion was started and the patient was extubated the next day without neurological deficits.

Conclusions Morel-Lavallée lesion is frequently underdiagnosed. In this case, EPC technique was essential to rule out intrathecal placement and was also the treatment for this condition. No similar case reports were found in literature.