Current management of intramural duodenal hematoma in alcohol induced pancreatitis

Intramural duodenal hematomas (IDH) have been rarely associated with pancreatic diseases. Conservative treatment is recommended, but course of disease can be life threatening, serious complications may occur (i.e. duodenal perforation) with imperative surgery. The management of diagnostic and treatm...

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Main Authors: Florian Bert, Thomas Jun, Siegbert Rossol
Format: Article
Language:English
Published: MDPI AG 2017-05-01
Series:Gastroenterology Insights
Subjects:
Online Access:http://www.pagepress.org/journals/index.php/gi/article/view/6818
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author Florian Bert
Thomas Jun
Siegbert Rossol
author_facet Florian Bert
Thomas Jun
Siegbert Rossol
author_sort Florian Bert
collection DOAJ
description Intramural duodenal hematomas (IDH) have been rarely associated with pancreatic diseases. Conservative treatment is recommended, but course of disease can be life threatening, serious complications may occur (i.e. duodenal perforation) with imperative surgery. The management of diagnostic and treatment in IDH has improved over the years. Computed tomography (CT) and endoscopic ultrasound are excellent tools for diagnosis and follow up of IDH. We report a case of a 31-year-old alcoholic who presented with vomiting, exsiccosis, hypochondriac pain and positive shock index. Esophagogastroduodenoscopy showed gastric outlet obstruction caused by obliterating tumor of bulbus duodeni. Initial suspicion was malign tumor of the duodenum confirmed by native CT and histology. Further diagnostic using EUS-guided aspirate resulted in IDH. By conservative management with nasogastric decompression and digestive rest the patient recovered. In course of disease the hematoma got smaller, but parts were still seen in CT 6 month later.
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spelling doaj.art-e949ec35bf79458d9810b796038d68202022-12-22T02:01:48ZengMDPI AGGastroenterology Insights2036-74142036-74222017-05-018110.4081/gi.2017.68183718Current management of intramural duodenal hematoma in alcohol induced pancreatitisFlorian Bert0Thomas Jun1Siegbert Rossol2Department of Internal Medicine, Krankenhaus Nordwest, Frankfurt am MainDepartment of Internal Medicine, Krankenhaus Nordwest, Frankfurt am MainDepartment of Internal Medicine, Krankenhaus Nordwest, Frankfurt am MainIntramural duodenal hematomas (IDH) have been rarely associated with pancreatic diseases. Conservative treatment is recommended, but course of disease can be life threatening, serious complications may occur (i.e. duodenal perforation) with imperative surgery. The management of diagnostic and treatment in IDH has improved over the years. Computed tomography (CT) and endoscopic ultrasound are excellent tools for diagnosis and follow up of IDH. We report a case of a 31-year-old alcoholic who presented with vomiting, exsiccosis, hypochondriac pain and positive shock index. Esophagogastroduodenoscopy showed gastric outlet obstruction caused by obliterating tumor of bulbus duodeni. Initial suspicion was malign tumor of the duodenum confirmed by native CT and histology. Further diagnostic using EUS-guided aspirate resulted in IDH. By conservative management with nasogastric decompression and digestive rest the patient recovered. In course of disease the hematoma got smaller, but parts were still seen in CT 6 month later.http://www.pagepress.org/journals/index.php/gi/article/view/6818pancreatitis, duodenal hematoma, complications, adenocarcinoma
spellingShingle Florian Bert
Thomas Jun
Siegbert Rossol
Current management of intramural duodenal hematoma in alcohol induced pancreatitis
Gastroenterology Insights
pancreatitis, duodenal hematoma, complications, adenocarcinoma
title Current management of intramural duodenal hematoma in alcohol induced pancreatitis
title_full Current management of intramural duodenal hematoma in alcohol induced pancreatitis
title_fullStr Current management of intramural duodenal hematoma in alcohol induced pancreatitis
title_full_unstemmed Current management of intramural duodenal hematoma in alcohol induced pancreatitis
title_short Current management of intramural duodenal hematoma in alcohol induced pancreatitis
title_sort current management of intramural duodenal hematoma in alcohol induced pancreatitis
topic pancreatitis, duodenal hematoma, complications, adenocarcinoma
url http://www.pagepress.org/journals/index.php/gi/article/view/6818
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