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An unusual case of hematemesis in a 12-month-old

Dana Mueller1, Luke Schroeder, Rahul Kaila

  • 1From the Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Minnesota, Minneapolis, MN.

Pediatric Emergency Care
|October 7, 2014
PubMed

Insights

Intramural duodenal hematoma, a rare complication of upper endoscopy, can cause hematemesis in infants. This case highlights the importance of considering this diagnosis in young children presenting with vomiting blood after the procedure.

Area of Science:

  • Pediatric Gastroenterology
  • Medical Imaging
  • Endoscopic Complications

Background:

  • Failure to thrive and hypothyroidism are significant pediatric conditions.
  • Hematemesis in infants warrants thorough investigation.
  • Upper endoscopy is a common diagnostic tool in pediatric work-ups.

Observation:

  • A 12-month-old male presented with recurrent hematemesis within 24 hours.
  • The patient had recently undergone an upper endoscopy and biopsy.
  • Ultrasound revealed findings suggestive of an intramural duodenal hematoma.

Findings:

  • The infant's hematemesis was attributed to an intramural duodenal hematoma.
  • Non-invasive management including intravenous hydration and nasogastric decompression was successful.
  • No invasive procedures or blood transfusions were required.

Implications:

  • Intramural duodenal hematoma is an uncommon but recognized complication of upper endoscopy.
  • Early diagnosis via imaging is crucial for appropriate management.
  • Conservative treatment is often effective for pediatric duodenal hematomas.

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