Abstract
In pediatric age, duodenal hematoma is rare and generally occurs following a closed abdominal trauma due to the crushing of the duodenum against the rigid plane of the spine; it rarely follows anticoagulant therapy, pancreatitis, bleeding disorders, vasculitis, tumors or upper digestive endoscopy. Duodenal hematoma is a rare cause of obstruction of the upper gastrointestinal tract and acute pancreatitis, and the diagnosis is sometimes difficult and late. On the other hand, the identification of the pathology in its initial stages allows the young patients to be subjected to a conservative treatment that resolves the issue most of the time, thus avoiding surgery. In this article we describe an unusual case of duodenal hematoma, following esophagus-gastro-duodenoscopy, in a 12-year-old boy with Di George syndrome.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Sidhu MK, Weinberger E, Healey P (1998) Intramural duodenal hematoma after blunt abdominal trauma. AJR Am J Roentgenol 170(1):38. https://doi.org/10.2214/ajr.170.1.9423594
Niehues SM, Denecke T, Bassir C, Hamm B, Haas M (2019) Intramural duodenal hematoma: clinical course and imaging findings. Acta Radiol Open 8(4):2058460119836256. https://doi.org/10.1177/2058460119836256
Zhou H, Ma X, Sheng M, Lai C, Fu J (2018) Evolution of intramural duodenal hematomas on magnetic resonance imaging. Pediatr Radiol 48(11):1593–1599. https://doi.org/10.1007/s00247-018-4178-9
Nolan GJ, Bendinelli C, Gani J (2011) Laparoscopic drainage of an intramural duodenal haematoma: a novel technique and review of the literature. World J Emerg Surg 6(1):42. https://doi.org/10.1186/1749-7922-6-42
Eichele DD, Ross M, Tang P, Hutchins GF, Mailliard M (2013) Spontaneous intramural duodenal hematoma in type 2B von Willebrand disease. World J Gastroenterol 19(41):7205–7208. https://doi.org/10.3748/wjg.v19.i41.7205
Peterson ML, Abbas PI, Fallon SC, Naik-Mathuria BJ, Rodriguez JR (2015) Management of traumatic duodenal hematomas in children. J Surg Res 99(1):126–129. https://doi.org/10.1016/j.jss.2015.04.015
McDonald-McGinn DM, Sullivan KE, Marino B, Philip N, Swillen A, Vorstman JA, Zackai EH, Emanuel BS, Vermeesch JR, Morrow BE, Scambler PJ, Bassett AS (2015) 22q11.2 deletion syndrome. Nat Rev Dis Primers 1:15071. https://doi.org/10.1038/nrdp.2015.71
Guzman C, Bousvaros A, Buonomo C, Nurko S (1998) Intraduodenal hematoma complicating intestinal biopsy case reports and review of the literature. Am J Gastroenterol 93(12):2547–2550. https://doi.org/10.1016/S0002-9270(98)00597-8
Diniz-Santos DR, de Andrade Cairo RC, Braga H, Araújo-Neto C, Paes IB, Silva LR (2006) Duodenal hematoma following endoscopic duodenal biopsy: a case report and review of the literature. Can J Gastroenterol 20(1):39–42. https://doi.org/10.1155/2006/391702
Esposito F, Di Serafino M, Mercogliano C, Ferrara D, Vezzali N, Di Nardo G, Martemucci L, Vallone G, Zeccolini M (2019) The pediatric gastrointestinal tract: ultrasound findings in acute diseases. J Ultrasound. 22(4):409–422. https://doi.org/10.1007/s40477-018-00355-0
Brillantino A, Rossi E, Bifano D, Minelli R, Tamasi S, Mamone R, Bignardi E, Zeccolini R, Zeccolini M, Vallone G (2020) An unusual onset of pediatric acute lymphoblastic leukemia. J Ultrasound. https://doi.org/10.1007/s40477-020-00461-y
Grasshof C, Wolf A, Neuwirth F, Posovszky C (2012) Intramural duodenal haematoma after endoscopic biopsy: case report and review of the literature. Case Rep Gastroenterol 6(1):5–14. https://doi.org/10.1159/000336022
Di Serafino M, Gioioso M, Severino R, Esposito F, Vezzali N, Ferro F, Pelliccia P, Caprio MG, Iorio R, Vallone G (2020) Ultrasound findings in paediatric cholestasis: how to image the patient and what to look for. J Ultrasound 23(1):1–12. https://doi.org/10.1007/s40477-019-00362-9
Minella R, Minelli R, Rossi E, Cremone G, Tozzi A (2020) Gastroesophageal and gastric ultrasound in children: the state of the art. J Ultrasound. https://doi.org/10.1007/s40477-020-00471-w
Di Serafino M, Vitale V, Severino R, Barbuto L, Vezzali N, Ferro F, Rossi E, Caprio MG, Raia V, Vallone G (2019) Pediatric ultrasonography of the pancreas: normal and abnormal findings. J Ultrasound 22(3):261–272. https://doi.org/10.1007/s40477-018-0348-8
Borsaru AD, Nandurkar D (2007) Intramural duodenal haematoma presenting as a complication after endoscopic biopsy. Australas Radiol 51(4):378–380. https://doi.org/10.1111/j.1440-1673.2007.01692.x
Di Serafino M, Severino R, Brigida R, Scarano E (2016) Cystic dystrophy of the duodenal wall in heterotopic pancreas: an atypical case in non-alcoholic female. BJR Case Rep 2(4):20160058. https://doi.org/10.1259/bjrcr.20160058
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Disclosures
The Authors declare that they have no conflict of interest.
Informed consent
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, and its late amendments. Additional informed consented was obtained from all patients for which identifying information is not included in this article.
Human and animal rights
This article does not contain any studies with human or animal subjects performed by any of the Authors.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Brillantino, C., Rossi, E., Baldari, D. et al. Duodenal hematoma in pediatric age: a rare case report. J Ultrasound 25, 349–354 (2022). https://doi.org/10.1007/s40477-020-00545-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40477-020-00545-9