Laparoscopic drainage of an intramural duodenal hematoma

Abstract

A 21-year-old man was admitted with vomiting and abdominal pain 3 days after sustaining blunt abdominal trauma by being tackled in a game of American football. A diagnosis of intramural hematoma of the duodenum was made using computed tomography and upper gastrointestinal tract contrast radiography. The hematoma caused obstructive jaundice by compressing the common bile duct. The contents of the hematoma were laparoscopically drained. A small perforation was then found in the duodenal wall. The patient underwent laparotomy and repair of the injury. Laparoscopic surgery can be used as definitive therapy in this type of abdominal trauma.

Successful management of large intramural duodenal haematoma causing obstructive jaundice with prolonged conservative treatment

“…6,9,12 New less invasive methods have been advocated such as laparoscopic drainage and CT guided percutaneous drainage of IDH after failed conservative treatment. 5,8 In this report, we describe a patient with IDH from blunt abdominal trauma who underwent successful conservative treatment despite obstruction of the common bile duct and relatively long period of bowel rest (33 days). Our observation was in agreement with previous report of successful outcome after 1 month of conservative treatment for IDH.…”

CT Guided Drainage of a Duodenal Hematoma After Trauma

“…4,5 It may be the result of a motor vehicle crash, sporting-related injury, child abuse, iatrogenic injury, or even a spontaneous bleed in a coagulopathic patient. 6 In our patient, a preceding seizure caused the patient to fall approximately 3 to 4 feet landing on his right flank. Evaluation usually involves the trauma surgery service, but because this patient was hemodynamically stable, had normal laboratory data, and a normal physical examination, the trauma service was not consulted.…”

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

“…To our knowledge this is the first report of the successful laparoscopic drainage of a duodenal hematoma, although there is a report on the laparoscopic drainage of IDH in the adult surgical literature, which was converted to open surgery owing to complications. 14 …”