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Conservative management of intestinal obstruction by isolated intramural duodenal hematoma. A case report and review of the literature.
- Source :
-
Annali italiani di chirurgia [Ann Ital Chir] 2015 Dec 07; Vol. 86 (ePub). Date of Electronic Publication: 2015 Dec 07. - Publication Year :
- 2015
-
Abstract
- 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.
- Subjects :
- Adult
Conservative Treatment methods
Drug Therapy, Combination
Duodenal Diseases diagnosis
Duodenal Diseases etiology
Early Diagnosis
Endoscopy, Digestive System methods
Endosonography methods
Hematoma diagnosis
Hematoma etiology
Humans
Intestinal Obstruction diagnosis
Intestinal Obstruction etiology
Male
Treatment Outcome
Abdominal Injuries complications
Duodenal Diseases therapy
Gastrointestinal Agents administration & dosage
Hematoma complications
Hematoma therapy
Intestinal Obstruction therapy
Parenteral Nutrition methods
Proton Pump Inhibitors administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 2239-253X
- Volume :
- 86
- Issue :
- ePub
- Database :
- MEDLINE
- Journal :
- Annali italiani di chirurgia
- Publication Type :
- Academic Journal
- Accession number :
- 26675664