Case of duodenal haematoma treated with ultrasound guided drainage

Abstract

Duodenal haematoma usually occurs secondary to blunt abdominal trauma(1), although more recently it has been recognized as a complication of endoscopic duodenal biopsy(2). The two established management strategies are to treat conservatively until resolution of the haematoma occurs or to surgically evacuate the haematoma. We present a case of duodenal haematoma that was successfully treated by ultrasound guided drainage when no improvement occurred with conservative treatment.

A curious case of spontaneous duodenal haematoma presenting a diagnostic challenge

“…They usually occur after blunt abdominal trauma, postulated to be due to the fixed retroperitoneal position of the duodenum tethered to the ligament of Treitz, thus predisposing it to deceleration injuries and leading to the disruption of the rich submucosal vascular plexus 2. Other less common aetiologies include inherited and acquired coagulopathies, regular warfarin use and postendoscopic biopsy 3–5.…”

Large duodenal hematoma associated with transcatheter arterial embolization following endoscopic hemostasis in a cirrhosis patient: Case report

“…There are two established treatment strategies for intraluminal hematoma: conservative treatment with nasogastric suction and intravenous fluids, or evacuation of the hematoma surgically (4,7). Other treatment options such as ultrasound-guided aspiration and endoscopic balloon dilatation (18), as well as endoscopic incision and drainage of the hematoma have also been reported (19).…”

“…Other treatment options such as ultrasound-guided aspiration and endoscopic balloon dilatation (18), as well as endoscopic incision and drainage of the hematoma have also been reported (19). Conservative management is considered the treatment of choice if the patient remains stable (7). Laparotomy may become necessary if there is unsatisfactory improvement with non-surgical treatment (4,7).…”

Duodenal Hematoma and Pancreatitis Complicating Endoscopic Intestinal Biopsy in a Boy with Noonan Syndrome

“…The clinical symptoms of presentation are severe abdominal pain and emesis. Acute pancreatitis is frequently associated as consequence of parietal hematoma conditioning ampullary obstruction [1,2,5,6,18]. For this reason duodenal biopsy should be obtained as far from the papilla as possible [2].…”

“…It can be a complication of duodenal biopsy, especially in patients with predisposing hemorrhagic diathesis [3,4] and can determine secondary pancreatitis because of ampullary hematoma [1,2,[5][6][7].…”