Abstract
We experienced a case of traumatic intramural hematoma of the duodenum which was observed endoscopically. A 14 years old male was admitted to our hospital because of upper abdominal pain and vomiting. Five hours before the admission, he had a strong blow to his abdomen with the ground while playing soccer. The upper gastrointestinal radiography showed stenosis at the level of the second and third portion of the duodenum which was diagnosed as intramural hematoma of the duodenum. We had started the conservative management with intravenous hyperalimentation and observed the regression of the hematoma on CT scan, ultrasonography and endoscopy. Endoscopic examination revealed the elevated lesion with dark-reddish color in the duodenal lumen on admission. After the successive treatment, these findings subsequently disappeared accompanied with the improvement of clinical symptoms. Through the conservative management, the patient could have a peroral diet on 16th hospital day and discharged on 37th hospital day. Our case suggests that duodenal hematoma may be treated conservatively in case with no other associated injuries, and that, in addition to CT scan and ultrasonography, endoscopy is very useful not only for the diagnosis but also follow-up of the duodenal intramural hematoma.
