Endoscopic dilatation as a new technique in managing pediatric duodenal hematoma

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Trauma Management

Background:

• Duodenal hematomas from blunt abdominal trauma are uncommon and typically managed non-surgically.
• Delayed presentation of symptoms, such as vomiting, can occur weeks after the initial injury.

Observation:

• A 10-year-old boy experienced progressive vomiting three weeks post-road traffic accident.
• Initial presentation suggested a complication from blunt abdominal trauma, specifically a duodenal hematoma.

Findings:

• Serial endoscopic interventions, including Controlled Radial Expansion (CRE) balloon dilatation, were performed four times over 11 weeks.
• The patient demonstrated a complete recovery with no symptoms at a 3-month follow-up post-treatment.

Implications:

• Esophagogastroduodenoscopy (EGD) with CRE balloon dilatation presents a viable, less invasive alternative to surgical management for symptomatic post-traumatic duodenal hematomas.
• This case supports the use of endoscopic techniques for managing pediatric duodenal hematomas, potentially reducing surgical morbidity.