Laparoscopic Drainage of a Post-Traumatic Intramural Duodenal Hematoma in a Child

Abstract

Duodenal intramural hematoma owing to blunt abdominal trauma is a relatively rare condition and is normally managed non-operatively. In this paper, we present the case of an 11-year-old boy with a post-traumatic duodenal hematoma, who after failing conservative management, underwent laparoscopic drainage. A four-port approach in a similar position to the laparoscopic cholecystectomy was used. After disentangling the inflammatory mass, the duodenal serosa was opened by simple hook diathermy and the hematoma evacuated. The child recovered uneventfully and was discharged home 48 hours later. To our knowledge, this is the first time that this condition has been successfully treated laparoscopically.

Laparoscopic drainage of an intramural duodenal haematoma: a novel technique and review of the literature

“…Banieghbal described a four port approach, similar to laparoscopic cholecystectomy, in an 11 year old child. An omental patch was applied on the serosa opening [13]. Maemura described an IDH in a 21 year old man following blunt abdominal trauma who required surgery due to evolving biliary obstruction [14].…”

Laparoscopic repair of traumatic abdominal wall hernia from handlebar injury

“…Laparoscopic abdominal exploration in cases of pediatric abdominal trauma has been described as a safe approach for hemodynamically stable patients, with repair of bowel injuries, diaphragm rupture, and inspection of solid organ injuries as long as the surgeon's laparoscopic skills are appropriate [13,15]. Two recent reports document the use of laparoscopy to repair traumatic pancreatic injury and to drain a duodenal hematoma [16,17].…”

Intramural duodenal hematoma and hemoperitoneum after endoscopic treatment in a patient with chronic renal failure on hemodialysis: a case report

“…Whereas in the past surgical evacuation or drainage was advised, current management of an intramural duodenal hematoma favors a conservative approach, including nasogastric suction and total parenteral nutrition [8,10-12]. Because the abundant blood supply of the duodenal wall is expected to absorb the hematoma promptly, the size of the hematoma does not appear to be a significant issue.…”