A Case of Traumatic Intramural Hematoma of the Duodenum Successfully Treated with Conservative Therapy

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  • 保存的に治癒し得た成人外傷性十二指腸壁内血腫の１例

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Abstract

The patient was a 19-year-old male. In August 2004, he fell off a motor cycle, and suffered trauma to his upperabdomen. He came to the emergency department of our hospital on the same day, but there were no abnormal findings, and he went home. After 2 days, vomiting and upper abdominal pain developed, and the patient presented at our hospital again 5 days after the injury. Computed tomography (CT) and ultrasonography revealed a phyma lesion measuring 7×4cm in diameter in the area of the duodenal horizontal duct and dilatation of the duodenum at the orifice-side, and the patient was admitted. On admission, his general condition was good. Contrast-enhanced radiography of the upper digestive tract showed compression in the duodenal descending area and passage disorder in the duodenal horizontal area. Upper digestive tract endoscopy revealed extramucosal compression and a protrusion in the duodenal horizontal area. Therefore, conservative therapy was performed under a diagnosis of duodenal intramural hematoma-related complete stenosis of the duodenal horizontal area. On contrast-enhanced radiography of the upper digestive tract 25 days after the injury, contrast medium passed through the small intestine. Abdominal CT confirmed the disappearance of the hematoma 30 days after the injury, and the patient was discharged 34 days after the injury.

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