Delayed Development of Obstructive Jaundice and Pancreatitis Resulting from Traumatic Intramural Hematoma of the Duodenum: Report of a Case Requiring Deferred Laparotomy

Takishima, T; Hirata, Mitsuho; Kataoka, Yuichi; Naito, Takehiko; Ohwada, Takashi; Kakita, Akira

doi:10.1097/00005373-200007000-00026

Cited by 17 publications

(19 citation statements)

References 8 publications

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“…14 Delayed bowel obstruction and jaundice often led to laparotomy cases. 15 Endoscopic drainage with mucosal puncture or fistula formation has also been performed without significant complications. 16 If accessible through the skin, percutaneous catheter insertion was also performed for decompression of IMDH.…”

Section: Discussionmentioning

confidence: 99%

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

Kim

Lee

Park

et al. 2020

Ann Hepatobiliary Pancreat Surg

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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. (Ann Hepatobiliary Pancreat Surg 2020;24:109-113)

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Section: Discussionmentioning

confidence: 99%

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

Kim

Lee

Park

et al. 2020

Ann Hepatobiliary Pancreat Surg

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“…2,10 Laparoscopic evacuation of the duodenal hematoma has shown promising results in various published case reports. 1,12,13,16 Most patients will recover within two weeks' time, and a follow-up CT scan of the abdomen will be useful for monitoring the resolution of the hematoma. 8,10 …”

Section: Discussionmentioning

confidence: 99%

An Unusual Cause of Intestinal Obstruction in an Adolescent: A Case Report

et al. 2009

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A 15-year-old boy presented with intestinal obstruction two weeks following a blunt abdominal trauma. He had progressive bilious vomiting without abdominal distension or peritonitis. The contrast computed tomography (CT) scan of the abdomen provided the definitive diagnosis: there was an obstructing duodenal hematoma, which might have been slowly progressing or have arisen from secondary hemorrhage after the initial injury. The boy remained stable over a ten-day period of conservative treatment, and his obstructive symptoms and signs were resolved completely. A follow-up CT scan of the abdomen (16 days after admission) showed an almost complete resolution of the hematoma. Delayed duodenal hematoma causing intestinal obstruction has been reported rarely in previous literature. Occasionally a significant secondary hemorrhage resulting in intestinal obstruction can become life threatening. Clinical follow-up is paramount after initial recovery. Although conservative treatment suffices in most cases, the surgeon should be wary of the need for definitive surgical intervention if there is evidence of ongoing acute hemorrhage or of the obstructing hematoma failing to resolve. Laparoscopic drainage of the hematoma provides optimistic results for patients failing conservative management.

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“…Non‐operative management of obstructive duodenal hematomas is more widely used, although some authors suggest that operative intervention may be more appropriate in some instances, particularly when lengthy periods of supportive treatment would be necessary 10 . In addition, the estimated weekly cost of hospitalization is higher after conservative treatment than after surgery 1 . A different conservative approach with ultrasonically guided percutaneous aspiration drainage and endoscopic balloon catheter dilation has been also proposed, in order to accelerate recovery and to reduce costs 12 …”

Section: Discussionmentioning

confidence: 99%

“…10 In addition, the estimated weekly cost of hospitalization is higher after conservative treatment than after surgery. 1 A different conservative approach with ultrasonically guided percutaneous aspiration drainage and endoscopic balloon catheter dilation has been also proposed, in order to accelerate recovery and to reduce costs. 12 In conclusion, duodenal forceps biopsy may be of substantial risk in a subgroup of patients, including those with hemostatic disorders and children with growth retardation.…”

Section: Discussionmentioning

confidence: 99%

Postbiopsy intramural hematoma of the duodenum in an adult with Noonan's syndrome

Sgouros¹,

Karamanolis²,

Papadopoulou³

et al. 2004

J of Gastro and Hepatol

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Intramural duodenal hematoma is a rare complication of endoscopic biopsy. It is usually seen in children with growth failure and in patients with bleeding disorders or who are anticoagulated. It is frequently associated with acute pancreatitis. We present a case of an adult patient with Noonan's syndrome who developed postbiopsy intraduodenal hematoma. Abdominal ultrasound and computed tomography scan established the diagnosis. Conservative treatment was successful. According to a brief review of the literature, patients with Noonan's syndrome may develop hematoma after sampling of the duodenum because they present all the main predisposing factors. Additionally, pulmonic valve stenosis may be another predisposing factor, but this may warrant further investigation.

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Delayed Development of Obstructive Jaundice and Pancreatitis Resulting from Traumatic Intramural Hematoma of the Duodenum: Report of a Case Requiring Deferred Laparotomy

Cited by 17 publications

References 8 publications

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

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

An Unusual Cause of Intestinal Obstruction in an Adolescent: A Case Report

Postbiopsy intramural hematoma of the duodenum in an adult with Noonan's syndrome

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