Related Experiment Videos
Intramural duodenal hematoma after upper gastrointestinal endoscopy
Katharina Hoenisch1, Rupert Prommegger, Hubert Schwaighofer
1Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria. katharina.hoenisch@gmail.com
Wiener Medizinische Wochenschrift (1946)
|October 22, 2011
Summary
Intramural duodenal hematoma is a rare complication following upper gastrointestinal endoscopy. Conservative management, including nutritional support, is effective for uncomplicated cases, leading to full recovery.
Area of Science:
- Gastroenterology
- Endoscopic Procedures
- Surgical Complications
Background:
- Intramural duodenal hematoma (IDH) is exceptionally rare, typically linked to blunt abdominal trauma in pediatric patients.
- Few cases of IDH post-upper gastrointestinal endoscopy (UGE) exist, often associated with bleeding disorders.
- Optimal management strategies for IDH remain a subject of ongoing discussion.
Observation:
- A 21-year-old female patient underwent UGE for dyspepsia and persistent hiccups, with biopsies taken.
- Post-procedure, she rapidly developed a complete duodenal obstruction due to intramural hematoma.
- The patient presented with symptoms of upper gastrointestinal obstruction.
Findings:
- Conservative treatment was initiated immediately after diagnosis of the duodenal hematoma.
- The patient received total parenteral nutrition and fluid/electrolyte management.
- Complete resolution of the duodenal obstruction occurred within three weeks.
Implications:
- Conservative management is a viable option for uncomplicated intramural duodenal hematomas.
- Prompt diagnosis and supportive care can lead to favorable outcomes.
- This case highlights the importance of considering IDH as a potential complication of UGE.
Related Concept Videos
01:28Esophageal 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...
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...
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
01:24Esophageal 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...
01:25Peptic 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...