Spontaneous Intramural Duodenal Hematoma in a Child (Case Report)

Abstract

Intramural duodenal hematoma is a very rare condition, a rare cause of a proximal gastrointestinal tract obstruction. It is most frequently been reported after blunt abdominal trauma in children. There are only few cases of intramural duodenal hematoma after upper gastrointestinal endoscopy. Most of them are associated with coagulation disorders. We present the unusual case of spontaneous intramural duodenal hemtoma as a cause of an intestinal obstruction: a 6-year-old male with abrupt onset of abdominal pain, ausea, and vomiting. Abdominal sonographic examination revealed a great mass consistent with blood measuring 79 × 86 × 50 mm on the head of the pancreas. The duodenal obstruction was confirmed on US and MRT. The patient was treated conservatively with total parenteral nutrition and gastric decompression during 42 hours, after this he underwent laparoscopic surgery to evacuate the hematoma. The results of the sonography and the short review of the literature is present.