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Large Duodenal Hematoma Causing an Ileus after an Endoscopic Duodenal Biopsy in a 6-Year-Old Child: A Case Report
Benjamin Schiller1, Michael Radke1, Christina Hauenstein2
1Department of Pediatrics, Rostock University Medical Center, 18057 Rostock, Germany.
Insights
Intramural duodenal hematoma (IDH) is a rare complication in children following esophagogastroduodenoscopy. This case highlights successful conservative management of a large IDH and pancreatitis in a previously healthy child.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Endoscopy
- Surgical Complications
Background:
- Intramural duodenal hematoma (IDH) is a rare complication post-esophagogastroduodenoscopy.
- IDH is often associated with underlying disorders or coagulopathy.
Observation:
- A previously healthy 6-year-old boy developed a large, obstructing IDH and pancreatitis after an elective esophagogastroduodenoscopy.
- Symptoms included abdominal pain, distension, nausea, and vomiting.
Findings:
- Diagnosis was confirmed via ultrasound and magnetic resonance imaging.
- Conservative management, including nasogastric decompression, bowel rest, parenteral nutrition, and analgesia, was effective.
Implications:
- This case demonstrates successful conservative treatment for pediatric IDH.
- Interdisciplinary discussion is recommended for refractory or complicated cases of pediatric IDH.
Abstract:
Intramural duodenal hematoma (IDH) in children is a rare complication after esophagogastroduodenoscopy. It is commonly described in patients with additional disorders or risk factors, such as coagulopathy. We present a case of a previously healthy 6-year-old boy with a large obstructing intramural duodenal hematoma and concomitant pancreatitis after an elective esophagogastroduodenoscopy. The patient presented with typical symptoms of an IDH, such as abdominal pain and distension, nausea and vomiting. IDH was diagnosed using ultrasound and magnetic resonance imaging examination. Conservative management with gastric decompression using a nasogastric feeding tube, bowel rest, total parenteral nutrition and analgesia was performed. After three weeks, the patient was discharged from the hospital without any complaints. Interventional management of IDH in pediatric patients with a lack of response to conservative therapy or complicating IDH should be discussed in an interdisciplinary team.
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