Jejunal Intramural Hematoma: Masquerading as a Mass Lesion

Area of Science:

• Pediatric Surgery
• Gastrointestinal Pathology
• Medical Imaging

Background:

• Jejunal intramural hematoma (JIH) is an uncommon gastrointestinal condition, particularly in pediatric patients.
• Paraneoplastic symptoms and attention-deficit hyperactivity disorder (ADHD) were noted in the patient, potentially influencing the clinical presentation.

Observation:

• Imaging revealed a suspected jejunal intramural mass with internal bleeding in a 5-year-old girl.
• Laparotomy confirmed the presence of a jejunal intramural hematoma.

Findings:

• Surgical evacuation of the hematoma was performed.
• Histopathological examination (HPE) definitively ruled out a neoplastic etiology for the jejunal mass.

Implications:

• This case highlights the importance of considering JIH in pediatric patients presenting with abdominal masses and bleeding, even with complex medical histories.
• The successful management through hematoma evacuation and HPE underscores the diagnostic and therapeutic approach for JIH.
• Further investigation into the potential link between paraneoplastic syndromes and JIH may be warranted.