Ann Hepatobiliary Pancreat Surg.  2020 Feb;24(1):109-113. 10.14701/ahbps.2020.24.1.109.

Conservative management of traumatic acute intramural hematoma of duodenal 2nd and 3rd portion: A case report and review of literature

• Kim SJ
• Lee JH
• Park SM
• Kwon KH

• KMID: 2471199
• DOI: http://doi.org/10.14701/ahbps.2020.24.1.109

Abstract

Traumatic intramural duodenal hematoma (IMDH) is a rare disease occurring usually in children. The treatment modality of traumatic IMDH varies according to clinical manifestations. We had a case of a young man who had traumatic IMDH and treated nonoperatively. He had 3 weeks of conservative care and has been discharged, with follow up abdominal CT scan showing complete resolution of the hematoma. In conclusion, patient with traumatic acute intramural hematoma of duodenal 2nd and 3rd portion have excellent clinical outcomes with conservative therapy.

Keyword

Hematoma; Duodenum; Trauma; Conservative management

MeSH Terms

Child
Duodenum
Follow-Up Studies
Hematoma*
Humans
Rare Diseases
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 (A), (B) are axial and coronal view of abdominopelvic CT, showing intramural hematoma of duodenum 2nd and 3rd portion. (C), (D) are endoscopic finding, showing extrinsic compression and ulcerative mass like lesion of duodenum 2nd and 3rd portion. (E), (F) are axial and coronal view of MRI, showing about 8.5×5.5×4.5 cm, acute intramural hematoma of duodenal 2nd and third portion.

• 

  Fig. 2 Abdominopelvic CT follow up taken on 14th day of admission showed minimal decrease in size of intramural hematoma of duodenum. (A) is axial view and (B) is coronal view.

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  Fig. 3 Abdominopelvic CT follow up taken on 7th week after diagnosis of IMDH showed completely resolved with very minimal periduodenal fluid left. (A) is axial view and (B) is coronal view.

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