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Traumatic intramural hematoma of the duodenum: report of one case
Yu-Cheng Lin1, Yun Chen, Shu-Jen Yeh
1Department of Pediatrics, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Pan-Chiao, Taipei Hsien, Taiwan. p92421006@ntu.edu.tw
Insights
Traumatic duodenal intramural hematoma is rare in children. Early diagnosis and conservative management, including nasogastric decompression and parenteral nutrition, can lead to successful outcomes in pediatric blunt abdominal trauma.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Trauma Management
Background:
- Traumatic intramural hematoma of the duodenum is an uncommon injury in pediatric patients.
- Prompt diagnosis is crucial for effective management of gastrointestinal obstruction.
Observation:
- A 10-year-old girl experienced sudden epigastric pain after abdominal trauma.
- She presented with severe symptoms of high gastrointestinal obstruction, including bilious nasogastric effluent.
- Imaging confirmed a large duodenal intramural hematoma.
Findings:
- The patient's condition was successfully managed conservatively.
- Treatment involved nasogastric decompression and total parenteral nutrition.
- The patient had an uneventful hospital course.
Implications:
- This case highlights the importance of considering duodenal intramural hematoma in the differential diagnosis of pediatric blunt abdominal trauma.
- Clinicians should maintain a high index of suspicion for this rare entity.
- Conservative management can be effective for traumatic duodenal intramural hematoma in children.
Abstract:
Traumatic intramural hematoma of the duodenum is a rare entity in children. A high clinical index of suspicion is necessary for early and accurate diagnosis. We report a 10-year-old girl presenting with a sudden onset of epigastralgia after impact on the epigastrium by the edge of a wooden bed while playing on it. Symptoms of high gastrointestinal obstruction were severe, with bilious and large amounts of nasogastric effluent. Image studies revealed a large hematoma extending from the second to the third portion of the duodenum. Her condition was managed successfully by conservative treatments with nasogastric decompression and total parenteral nutrition. Her hospital course was uneventful. This report serves as a reminder to clinicians to consider intramural hematoma of the duodenum in the differential diagnosis of blunt abdominal trauma.
