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Idiopathic Retroperitoneal Hematoma with Spontaneous Resolution
Yu Jeong Hwang1, Suk Je Jin1, Yong Jin Jeong1
1Department of Internal Medicine, Saint Carollo Hospital, Suncheon, Korea.
The Korean Journal of Gastroenterology = Taehan Sohwagi Hakhoe Chi
|November 26, 2021
Summary
A rare case of idiopathic retroperitoneal hematoma in a 54-year-old man resolved spontaneously. Conservative management led to complete resolution and discharge, highlighting a non-surgical approach for duodenal hematomas.
Area of Science:
- Gastroenterology
- Radiology
- General Surgery
Background:
- Idiopathic retroperitoneal hematomas are rare, particularly those involving the duodenum.
- Prompt diagnosis and appropriate management are crucial for patient outcomes.
Observation:
- A 54-year-old male presented with symptoms of duodenal obstruction due to a large retroperitoneal hematoma.
- Abdominal CT revealed a 9 cm hematoma compressing the third portion of the duodenum, causing stenosis.
- Upper endoscopy confirmed duodenal stenosis without mucosal lesions.
Findings:
- The patient was managed conservatively due to the subacute nature of the hematoma.
- Serial CT scans demonstrated significant reduction in hematoma size, from 9.0 cm to 5.8 cm.
- Complete resolution of the hematoma was observed on follow-up imaging.
Implications:
- This case suggests that conservative management can be effective for select cases of idiopathic retroperitoneal duodenal hematomas.
- Spontaneous resolution is a possible outcome, potentially avoiding surgical intervention.
- Highlights the importance of multidisciplinary assessment in managing complex gastrointestinal conditions.
