TY - JOUR
T1 - Conservative management of intestinal obstruction by isolated intramural duodenal hematoma: A case report and review of the literature
AU - D'Arpa, Francesco
AU - Battaglia, Emanuele Onofrio
AU - Tutino, Roberta
AU - Gulotta, Gaspare
AU - Salamone, Giuseppe
AU - Orlando, Giuseppina
PY - 2015
Y1 - 2015
N2 - The duodenal injuries occur in the 3-5% of blunt abdominal traumas. The isolated intramural duodenal hematoma is a very rare lesion. An early diagnosis and an adequate therapy are crucial because a delay, beyond 24 hours, increases the mortality from the 11% to 40%. However, diagnosis is often hindered by a lack of specific symptoms. We report a case of a 21 years-old man with an intestinal obstruction from isolated intramural duodenal hematoma occurred after a blunt abdominal trauma in a sport competition. The patient was treated conservatively with total parenteral nutrition, gastric decompression and intravenous PPIs. The progressive spontaneous resolution of the hematoma was checked with periodical endoscopies. The discharge occurred after three weeks with no early complications. No late complications occurred at one-year follow-up. The endoscopy is a good and safe tool in the management of this intestinal obstructions with the possibility of conservative or interventional treatment.
AB - The duodenal injuries occur in the 3-5% of blunt abdominal traumas. The isolated intramural duodenal hematoma is a very rare lesion. An early diagnosis and an adequate therapy are crucial because a delay, beyond 24 hours, increases the mortality from the 11% to 40%. However, diagnosis is often hindered by a lack of specific symptoms. We report a case of a 21 years-old man with an intestinal obstruction from isolated intramural duodenal hematoma occurred after a blunt abdominal trauma in a sport competition. The patient was treated conservatively with total parenteral nutrition, gastric decompression and intravenous PPIs. The progressive spontaneous resolution of the hematoma was checked with periodical endoscopies. The discharge occurred after three weeks with no early complications. No late complications occurred at one-year follow-up. The endoscopy is a good and safe tool in the management of this intestinal obstructions with the possibility of conservative or interventional treatment.
UR - http://hdl.handle.net/10447/216531
UR - http://www.annaliitalianidichirurgia.com/
M3 - Article
VL - 86
JO - ANNALI ITALIANI DI CHIRURGIA
JF - ANNALI ITALIANI DI CHIRURGIA
SN - 0003-469X
ER -