Intramural duodenal hematoma: an unusual complication of endoscopic small bowel biopsy

We report a case of intestinal obstruction secondary to intramural duodenal hematoma after endoscopic small bowel biopsy. Review of the literature indicates that intramural duodenal hematoma occurs mainly in infants and children after trauma to the abdomen. The diagnosis can be made by upper gastrointestinal series and confirmed by computerized axial tomography of the abdomen. Conservative management in the form of nasogastric suction and total parenteral nutrition resulted in amelioration of obstructive symptoms within 10 days. Physicians should be alerted to the possibility of developing intramural duodenal hematoma after small bowel biopsy. This is the first report of such an unusual complication after endoscopic small bowel biopsy in children.