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Intramural haematoma of the alimentary tract in children
S Chittmittrapap1, B Chandrakamol, S Chomdej
1Department of Surgery, Chulalongkorn University Hospital, Bangkok, Thailand.
Insights
Intramural hematomas in children, often caused by trauma, typically present with vomiting and abdominal pain. Conservative treatment proved highly effective, with 12 of 13 cases recovering without complications.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Surgery
Background:
- Intramural hematoma of the alimentary tract is a rare condition in children.
- It can result from trauma, coagulation defects, or have an unknown etiology.
Purpose of the Study:
- To review the clinical presentation, diagnosis, and management of intramural hematoma in children.
- To evaluate the efficacy of conservative treatment.
Main Methods:
- Retrospective case series of 13 children treated between 1978 and 1986.
- Review of medical records, including history, clinical presentation, diagnostic studies, and treatment outcomes.
Main Results:
- Trauma was the leading cause in 11 cases; one case was linked to a snake bite with coagulation defect.
- Vomiting and abdominal pain were the most common symptoms.
- Upper gastrointestinal contrast studies were diagnostic.
- Conservative management was successful in 12 out of 13 patients, with no reported morbidity or mortality.
Conclusions:
- Intramural hematoma in children is often associated with trauma.
- Conservative management is a safe and effective treatment strategy.
- Prompt diagnosis via contrast studies leads to favorable outcomes.
Abstract:
Thirteen children with intramural haematoma of the alimentary tract were treated in Chulalongkorn University Hospital during an 8-year period (1978-1986). A history of trauma was obtained in 11 cases, 1 case presented as a result of a coagulation defect secondary to a haematotoxic snake bite and no causative factor was apparent in 1 patient. Profound vomiting with abdominal pain is the typical presentation. Upper gastrointestinal contrast study is usually characteristic and diagnostic. Conservative treatment was successful in 12 of the cases with no morbidity and mortality.