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[Post-traumatic intramural hematoma of the duodenum]
Insights
Post-traumatic duodenal intramural hematoma in a child was managed conservatively. Follow-up imaging confirmed normal transit by day 12, highlighting non-surgical options for this pediatric injury.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Radiology
Background:
- Intramural hematoma of the duodenum is typically caused by injury, frequently affecting young males.
- Symptoms often mimic upper digestive tract obstruction.
- Diagnosis requires careful imaging due to perforation risks.
Abstract:
A post-traumatic intramural hematoma of duodenum in a 9 year old child was detected during exploratory laparotomy but left undisturbed. Postoperative follow up during parenteral feeding included surveillance by repeated gastrografin follow through examinations, normal transit being restored by the 12th day. Intramural hematoma of duodenum is usually due to injury and often affects male children. Symptomatology is that of upper digestive occlusion. The principal investigation should be gastro-duodenal follow through examinations with gastrografin, because of the risk of an associated perforation, to reveal possible partial or total duodenal obstruction. Conservative treatment is possible, but in case of failure or in adults surgery is indicated with evacuation of the hematoma and in some cases a gastro-jejunostomy.
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