PMC9647285_01
Right-leg deep dissecting hematoma at admission.
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A 70-year-old woman was referred to our emergency department with a sizable, painful pretibial hematoma located in the back of the right leg, ending just above the ankle (Figure 1).
Lacerations and superficial hematomas in the forearms as signs of
dermatoporosis.
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On skin examination, senile purpura, atrophy, large lacerations, and superficial hematomas were found in the forearms, indicating severe dermatoporosis (Figure 2).
Transversal view of the deep dissecting hematoma during soft tissue
sonographic study of the right leg.
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A Doppler US examination ruled out a deep vein thrombosis (DVT) and revealed a well-defined hypo/heterogeneous mass between the skin and muscle fascia (Figure 3).
Right-leg deep dissecting hematoma 4 h after admission at the Emergency
Department, extending to the upper part of the calf (a) and dorsum of the
foot (b).
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Four hours after admission, while the pain was not alleviated by usual analgesics, the hematoma had spread to the upper part of the calf (Figure 4(a)), went on, reached the dorsum of the foot (Figure 4(b)) and eventually self-opened with pain relief.
Significant loss of substance after surgical debridement and drainage of the
right-leg deep dissecting hematoma (a). Right-leg wound 4 months after
surgery (b).
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The post-operative wound was extensive, deep, exudative and painful (Figure 5(a)). Complete re-epidermisation was achieved within 4 months (Figure 5(b)) without any infection or bleeding.