Abstract
We report the case of a 7-year-old girl with intestinal obstruction due to post-traumatic intramural duodenal hematoma. She had fallen from the monkey bars the day before presenting to our hospital, and was admitted with signs of abdominal pain, vomiting, and nausea. Abdominal ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) demonstrated a heterogeneous solid mass located within the duodenal wall, compressing the descending part of the duodenum. The inferior vena cava was also compressed by the mass lesion, although no associated symptoms were evident. Based on these findings, the mass lesion was considered to represent intramural hematoma causing intestinal obstruction. She was managed conservatively with total parenteral nutrition. Although CT and MRI are useful for differentiating hematoma from other intestinal tumors, ultrasonography is minimally invasive and easier to perform repeatedly. In case of duodenal hematoma, ultrasonography may be quite helpful for diagnosis and follow-up by monitoring tumor size and characteristics, and the degree of duodenal compression during conservative treatment.
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Acknowledgments
We wish to thank the sonographer, Ms. C. Sasakawa, and the staff of the Department of Clinical Laboratory (Ultrasound) in the Medical Technology Division of Tokushima Central Prefectural Hospital, whose continued support and advice were indispensable in the creation of this article.
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Yukako Homma and all other authors declare that they have no conflict of interest.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all patients prior to inclusion in the study.
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Homma, Y., Mori, K., Ohnishi, Y. et al. Ultrasound follow-up in a patient with intestinal obstruction due to post-traumatic intramural duodenal hematoma. J Med Ultrasonics 43, 431–434 (2016). https://doi.org/10.1007/s10396-016-0717-x
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DOI: https://doi.org/10.1007/s10396-016-0717-x