Intramural Duodenal Hematoma Mimicking an Intestinal Mass on Sonography

Ghersin, Eduard; Gaitini, Diana; Wills, Orly; Soudack, Michal; Engel, Ahuva

doi:10.7863/jum.2002.21.6.693

Cited by 14 publications

(14 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…La ecografía nos permite observar la integridad duodenal y lesiones asociadas. Los signos más comunes son el signo de "doble burbuja" y el signo de la "vela de viento " (26,27) también tiene participación en el período prenata l, siendo el polihidramnios un signo sugestivo de obstrucción duodenal (28,29) Las membranas duodenales a su vez pueden ser hallazgos incidentales en el examen gastrointestinal con bario durante un TEGD. La retención de bario a nivel duodenal por más de 6 horas es sugestiva de su presencia (7)(8)(9).…”

Section: Discussionunclassified

Membranas Duodenales: Diagnósticos tardíos evidenciados por cuerpos extraños

Cevallos

Velarde

Dávila

et al. 2017

Pediatr

View full text Add to dashboard Cite

Aceptado el 5 de octubre de 2016 Palabras clave:Membrana duodenal cuerpos extraños R E S U M E N Una de las causas de obstrucción duodenal congénita incompleta es la presencia de membranas duodenales, cuyo diagnóstico oportuno y preciso requiere un alto grado de sospecha.Presentamos dos casos de obstrucción duodenal con diagnóstico inicial de presencia de cuerpos extraños, razón por la cual los pacientes fueron sometidos a una intervención quirúrgica en la que se les encontraron membranas duodenales incompletas. La evolución clínica de estos pacientes tuvo un patrón distinto a lo esperado. Por esta razón, consideramos necesario abordar a este grupo de pacientes con un método multidisciplinar, distinto de aquel con que se procede en el caso de otros subtipos de obstrucciones duodenales. Duodenal Membranes: Late diagnoses evidenced by foreign bodies A B S T R A C TOne of the causes of congenital incomplete duodenal obstruction is the presence of duodenal membranes, which requires a high degree of suspicion for a timely and accurate diagnosis. We present two cases of duodenal obstruction with an initial diagnosis of foreign bodies, reason why the patients underwent a surgery in which incomplete duodenal membranes were detected. The clinical course of these patients displayed different patterns than expected. For this reason, we consider imperative to address this group of patients with a multidisciplinary method, different from that with which it is proceeded in the case of other subtypes of duodenal obstruction.

show abstract

Section: Discussionunclassified

Membranas Duodenales: Diagnósticos tardíos evidenciados por cuerpos extraños

Cevallos

Velarde

Dávila

et al. 2017

Pediatr

View full text Add to dashboard Cite

show abstract

“…Color-coded imaging has been shown to be helpful in differentiating a spontaneous DH from an intestinal mass. 8 Sonography may be the first examination performed in a patient with epigastric abdominal pain or a palpable abdominal mass, 8 and it is useful to be familiar with this uncommon entity. In BAT, sonography can additionally show associated lesions, including pancreatic traumatic pseudocysts and parenchymal lacerations, or a small amount of ascites caused by peritoneal blood or pancreatic fluid.…”

Section: A Discussionmentioning

confidence: 99%

“…The clinical appearance and findings including abdominal pain, vomiting, tenderness, and a palpable mass can be nonspecific, accompanied by unremarkable laboratory test results. 6,8 Blunt abdominal trauma, sometimes minor, is the leading cause of DHs, which occur in approximately four fifths of patients. 9,10 Bleeding disorders, Henoch-Schönlein purpura, anticoagulation therapy, alcoholism, pancreatitis, tumors, duodenal ulcers, and local or iatrogenic factors are other implicative causes.…”

Section: A Discussionmentioning

confidence: 99%

“…Sonography is considered a reliable screening tool for blunt abdominal trauma (BAT) 3,4 ; however, since the beginning of the last decade, only a small number of reported DH cases [5][6][7][8] have been described by sonography. We illustrate the sonographic findings at the diagnosis and follow-up of a traumatic DH in a young man who was treated expectantly.…”

Section: 2mentioning

confidence: 99%

See 1 more Smart Citation

Sonographic Diagnosis and Monitoring of an Obstructing Duodenal Hematoma After Blunt Trauma

Megremis

Segkos

Andrianaki

et al. 2004

Journal of Ultrasound in Medicine

View full text Add to dashboard Cite

traumatic duodenal hematoma (DH) is an unusual event, occurring mainly in children and young individuals, with a male predominance in both age groups. Furthermore, it can be a diagnostic challenge because of unreliable history, nonspecific signs and symptoms, delayed appearance, and the duodenum's retroperitoneal location. 1,2Sonography is considered a reliable screening tool for blunt abdominal trauma (BAT) 3,4 ; however, since the beginning of the last decade, only a small number of reported DH cases 5-8 have been described by sonography. We illustrate the sonographic findings at the diagnosis and follow-up of a traumatic DH in a young man who was treated expectantly. We also present the sonographic findings of the resulted complete obstruction of the upper gastrointestinal (GI) tract and the DH's postoperative sonographic appearance.

show abstract

“…One small intestinal hematoma was reported in 2500 cases using oral anticoagulants [2]. Ultrasonography and CT findings of intramural hematomas might imitate massive formations [3]. The patient history and INR levels are important for the diagnosis.…”

mentioning

confidence: 99%

CT findings of Intramural Small Bowel Hematoma Secondary to use of Oral Anticoagulant Therapy

Karadeli¹,

Tok²,

Erbay³

2016

Ann Clin Anal Med

View full text Add to dashboard Cite

" [1] presented by İbrahim Yetim and colleagues in your journal. We wanted to mention a case diagnosed by clinical, laboratory and CT findings and treated non-surgically that might contribute to the valuable article. Oral anticoagulants are used for reasons like atrial fibrillation and venous thrombosis. One small intestinal hematoma was reported in 2500 cases using oral anticoagulants [2]. Ultrasonography and CT findings of intramural hematomas might imitate massive formations [3]. The patient history and INR levels are important for the diagnosis. The diagnosis can be confirmed by endoscopic biopsies [4]. In the treatment, hemostasis is obtained and the regression of the hematoma is monitored. Rarely, surgery is needed. In literature, surgery has been performed in cases where spontaneous regression does not occur or necrosis or peritonitis develops and if the diagnosis is unclear [4]. The 55 year old female case presented with a 3 day history of diffuse abdominal pain and no gas or stool passage. She had been using Coumadin after an ASD operation for atrial fibrillation. Physical examination revealed diffuse abdominal defense. The laboratory test results were high, APTT was 93.70 sec, PT was 111.30 sec and INR was 15.96. In the CT scans with and without contrast, thickening of the intestinal wall was observed in the pelvic region and the mean density was measured 50HU in the scan without contrast and 55HU in the contrasted scan [ figure 1]. In the proximal of the intestines defined, diffuse dilatation consistent with ileus was identified. A minimal degree of free fluid was observed. The SMA and SMV were intact in the contrasted images. With consideration of the patient's INR values the findings were primarily regarded in favor of an intramural hematoma. Coumadin was stopped and a heparin infusion was started. After the INR levels and abdominal complaints resolved the Coumadin treatment was continued. In the CT scans obtained, regression of the intramural thickness and dilatation of the small intestines was noted [ figure 2]. As a conclusion, the diagnosis of intramural hemorrhage can be made according to the clinical, laboratory and radiologic findings. In the following, INR levels and ultrasound and CT findings are important. Ultrasonography is noninvasive, so it may be first prefer in the following. The treatment can be stopping coumadin treatment and performing surgery if the situation does not resolve depending on the clinical picture.

show abstract

Intramural Duodenal Hematoma Mimicking an Intestinal Mass on Sonography

Cited by 14 publications

References 10 publications

Membranas Duodenales: Diagnósticos tardíos evidenciados por cuerpos extraños

Membranas Duodenales: Diagnósticos tardíos evidenciados por cuerpos extraños

Sonographic Diagnosis and Monitoring of an Obstructing Duodenal Hematoma After Blunt Trauma

CT findings of Intramural Small Bowel Hematoma Secondary to use of Oral Anticoagulant Therapy

Contact Info

Product

Resources

About