Spontaneous intramural duodenal hematoma in a young woman

Czech version

Authors: P. Vrbová; Koller T.
Authors‘ workplace: V. interná klinika LF UK a UN Bratislava
Published in: Gastroent Hepatol 2021; 75(6): 535-538
Category:
doi: https://doi.org/10.48095/ccgh2021535

Overview

Non-traumatic spontaneous intramural duodenal hematoma is a rare cause of proximal gastrointestinal obstruction which may present with hemorrhage, jaundice and pancreatitis. In this case report we present a case of spontaneous duodenal hematoma in a 28-year-old female with a history of acute pancreatitis, admitted to hospital for convulsive upper abdominal pain with vomiting as suspected pancreatitis. An MRI examination of the abdomen confirmed intraluminal bleeding into the duodenum. Following supportive therapy the clinical symptoms spontaneously subsided and laboratory parameters improved. Due to early diagnosis and therapy the patient had a good outcome, without requiring surgery. Repeated imaging showed hematoma resorption.

Keywords:

Hemorrhage – Abdominal pain – vomitus – duodenal hematoma

Sources

1. Kumar R, Athwal PSS, Kumar M et al. Spontaneus intramural duodenal hematoma: a rare complication of pancreatitis. Cureus 2020; 12 (6): e8491. doi: 10.7759/cureus.8491.

2. Oliveira JHB, Esper RS, Ocariz RC et al. Intramural duodenal hematoma secondary to pancreatitis: case report and review of the literature. Sao Paulo Med 2018; 136 (6): 597–601. doi: 10.1590/1516-3180.2017.0134290517.

3. Azcón FM, Martínez AM, Chinchilla AS et al. Findings in spontaneous intramural intestinal hematoma imaging. Rev Argent Radiol 2016; 80 (1): 39–44.

4. McLauchlan J. Fatal false aneurysmal tumour occupying nearly the whole of the duodenum. Lancet 1838; 2: 203–205.

5. Sutherland GA. Intussusception and Henoch’s purpura. Br J Dis Child 1904; 1: 23–28.

6. Von Khautz A. Darmstenose durch submuköse Hämatome bei Hämophilie. Arch Klin Chir 1908; 87: 542–551.

7. Euroboonyanun CH, Somsap K, Ruangwannasak S et al. Spontaneus intramural duodenal hematoma: pancreatitis, obstructive jaundice, and upper intestinal obstruction. Case Rep Surg 2016; 2016: 5321081. doi: 10.1155/2016/5321081.

8. Kunčák B, Páv I. Spontánny intramurálny hematóm tenkého čreva ako komplikácia antikoagulačnej liečby. Gastroent Hepatol 2012; 66 (6): 477–481.

9. Abbas MA, Collins JM, Olden KW. Spontaneus intramural small-bowel hematoma: imaging findings and outcome. AJR Am J Roentgenol 2002; 179 (6): 1389–1394. doi: 10.2214/ajr.179.6. 1791389.

10. Samie AA, Sun R, Huber A et al. Sponteaneous intramural small-bowel hematoma secondary to anticoagulant therapy: a case series. Med Klin Intensivmed Notfmed 2013; 108 (2): 144–148. doi: 10.1007/s00063-012- 0184-0.

11. Kang EA, Han SJ, Chun J et al. Clinical features and outcomes in spontaneous intramural small bowel hematoma: cohorot study and literature review. Intest Res 2019; 17 (1): 135–143. doi: 10.5217/ir.2018.00085.

12. Amankwa AT, Graft-Johnson ED, Twum KA et al. A case of spontaneus intramural duodenal hematoma in a young African man: Imaging findings. Radiol Case Rep 2021; 16 (7): 1675–1678. doi: 10.1016/j.radcr.2021.03.070.

13. Sorbello MP, Utiyama EM, Parreira JG et al. Spontaneous intramural small bowel hematoma induced by anticoagulant therapy: review and case report. Clinics (Sao Paulo) 2007; 62 (6): 785––790. doi: 10.1590/s1807-59322007000600020.

14. Lee JY, Chung JS, Kim TH. Successful endoscopic decompression for intramural duodenal hematoma with gastric outlet obstruction complicating acute pancreatitis. Clin Endosc 2012; 45 (3): 202–204. doi: 10.5946/ce.2012.45.3.202.