Elmoghazy W, Noaman I, Mahfouz AE, Elaffandi A, Khalaf H. Surgical management of complicated intra-mural duodenal hematoma: A case-report and review of literature.
Int J Surg Case Rep 2015;
17:103-5. [PMID:
26595897 PMCID:
PMC4701797 DOI:
10.1016/j.ijscr.2015.10.028]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 10/19/2015] [Accepted: 10/20/2015] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION
Intramural duodenal hematoma (IDH) is a rare pathological entity that occurs as a complication of trauma, pancreatitis, peptic ulcer disease or endoscopic biopsy procedures. In this report, we present a case of IDH related to a duodenal diverticulum that was complicated by intra-abdominal bleeding and peritonitis.
PRESENTATION OF CASE
We report a 31-year old male who presented with pancreatitis that was complicated with IDH, as diagnosed using endoscopy and CT scan of the abdomen. The condition was related to a duodenal diverticulum as appears on imaging. The patient was treated conservatively over a course of 1 week when he started to have intra-abdominal bleeding and developed peritonitis. The patient was successfully treated with laparotomy, drainage of intra-abdominal abscess, evacuation of IDH and repair of duodenal perforation. We discuss this case in the context of the current indications of surgery in cases of IDH.
CONCLUSION
Despite shift towards conservative management of IDH cases over last few decades, these cases should be handled carefully as they might develop life-threatening complications.
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