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[Post-traumatic intramural hematomas of the duodenum in children. Apropos of 2 cases]
T Scheye1, G Vanneuville, A Deubelle
1Service de Chirurgie Pédiatrique, Hôtel-Dieu, Clermont-Ferrand.
Insights
Intramural duodenal hematoma in children can be treated surgically or non-surgically. Non-operative management is recommended when perforation or other surgical complications are ruled out.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Intramural duodenal hematoma (IDH) is a rare condition in children, often associated with trauma.
- Accurate diagnosis and appropriate management are crucial for favorable outcomes.
Observation:
- Two pediatric cases of intramural duodenal hematoma were reviewed.
- One patient underwent surgical evacuation of the hematoma.
- The second patient was successfully managed non-operatively with nasogastric suction and intravenous fluids.
Findings:
- Non-operative management is a viable option for intramural duodenal hematoma.
- Surgical intervention may be necessary in specific circumstances.
Implications:
- This study highlights the importance of careful patient selection for non-operative treatment of IDH.
- Excluding duodenal perforation and other surgical emergencies is key to successful non-operative management.
- Further research into optimal treatment strategies for pediatric IDH is warranted.
Abstract:
Two children in whom the diagnosis of intramural duodenal hematoma was made have been treated. One patient had the hematoma evacuated at surgery and one was successfully managed with nasogastric suction and parenteral fluid administration. The non operative treatment for intramural duodenal hematoma is recommended after perforation of the duodenum (type IIB, III, IV) or other associated injuries requiring laparotomy have been satisfactorily excluded.