Related Experiment Videos

Intramural hematoma of duodenum: An unusual complication after endoscopic therapy for a bleeding peptic ulcer

Ramesh Kumar1, Manoj Kumar Sharma, Vikram Bhatia

  • 1Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.

Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine
|August 5, 2011
PubMed

Insights

Intramural hematoma of the duodenum (IDH) is a rare complication after endoscopic ulcer treatment. This case highlights IDH in an adult with kidney disease, resolving with conservative care.

Area of Science:

  • Gastroenterology
  • Endoscopy
  • Nephrology

Background:

  • Intramural hematoma of the duodenum (IDH) is an uncommon condition, typically associated with pediatric blunt abdominal trauma.
  • Endoscopic interventions for bleeding peptic ulcers can rarely lead to IDH.

Observation:

  • A case of IDH developed in an adult patient with end-stage renal disease (ESRD) after endoscopic therapy for a bleeding duodenal ulcer.
  • The hematoma manifested two days post-intervention, causing temporary duodenal obstruction.

Findings:

  • The duodenal hematoma resolved spontaneously within one week.
  • Conservative management was effective in treating the obstruction and hematoma.

Implications:

  • This case expands the known clinical spectrum of IDH, particularly in adult patients with ESRD undergoing endoscopic procedures.
  • Highlights the importance of considering IDH as a differential diagnosis in patients presenting with upper gastrointestinal symptoms post-endoscopy.
  • Suggests conservative management may be a viable approach for IDH in select adult populations.

Keywords:
Duodenal hematomaendotherapyulcer bleeding

Related Concept Videos

Peptic Ulcer Disease III: Clinical Manifestations and Complications01:25

Peptic Ulcer Disease III: Clinical Manifestations and Complications

Duodenal UlcersDuodenal ulcers are the most common form of peptic ulcer disease, presenting with chronic, intermittent epigastric pain. Pain typically appears 2–3 hours after meals, especially when the stomach is empty, often waking patients at night. It is characteristically relieved by food or antacids (“pain–food–relief”). Some patients remain asymptomatic until complications like bleeding or perforation emerge, particularly with NSAID or anticoagulant use.Gastric UlcersGastric ulcers share...
Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Peptic Ulcer01:27

Peptic Ulcer

Peptic ulcers are erosive lesions of the gastric or duodenal lining, most commonly caused by Helicobacter pylori infection. This Gram-negative, helical bacterium has adapted to survive the stomach’s acidic environment by producing urease, which converts urea into ammonia and carbon dioxide. The ammonia neutralizes gastric acid in the bacterium’s immediate environment, allowing colonization of the gastric mucosa. H. pylori attaches to mucus-secreting epithelial cells, penetrates the mucus...
Esophageal Varices-I: Introduction01:24

Esophageal Varices-I: Introduction

Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies01:28

Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies

Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.