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Delayed duodenal hematoma and pancreatitis from a seatbelt injury

Katherine Deambrosis1, Manjunath S Subramanya, Breda Memon

  • 1Department of Surgery, Ipswich Hospital, Ipswich, Queensland, Australia.

The Western Journal of Emergency Medicine
|June 22, 2011
PubMed

Insights

Traumatic duodenal hematoma, a rare pediatric injury from blunt abdominal trauma, can be challenging to diagnose. This case highlights successful conservative management of a delayed presentation in a 15-year-old, leading to complete resolution.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Trauma Surgery

Background:

  • Traumatic duodenal hematoma is a rare consequence of blunt abdominal trauma in children.
  • Delayed diagnosis increases morbidity due to potential occult injuries to adjacent structures.
  • Conservative management is often successful, with a generally good prognosis.

Purpose of the Study:

  • To report a case of a pediatric patient with a delayed presentation of traumatic duodenal hematoma.
  • To illustrate the successful conservative treatment of duodenal hematoma and associated acute pancreatitis.
  • To emphasize the importance of considering duodenal hematoma in pediatric blunt abdominal trauma.

Main Methods:

  • Case report of a 15-year-old male with blunt abdominal trauma.
  • Diagnostic workup including imaging to identify duodenal hematoma and pancreatitis.
  • Conservative management approach focusing on supportive care.

Main Results:

  • The patient presented with delayed symptoms of duodenal hematoma and acute pancreatitis.
  • Conservative treatment led to complete resolution of both the hematoma and pancreatitis.
  • No surgical intervention was required.

Conclusions:

  • Conservative management is a viable and effective approach for pediatric traumatic duodenal hematoma, even with delayed presentation.
  • Early recognition and prompt conservative treatment can lead to favorable outcomes.
  • This case underscores the importance of a high index of suspicion for duodenal injuries in pediatric blunt abdominal trauma.

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