抄録
A 21-year-old man lost control of his bicycle and crashed into a guardrail. He was admitted to a local hospital the next day with severe abdominal pain. He was treated for acute pancreatitis diagnosed based on abdominal tenderness and increased serum amylase. Six days after the accident, he was transferred to our hospital due to elevated temperature and total bilirubin. Computed tomography (CT) showed a large cystic mass occupying the second and third portions of the duodenum, a swollen diffusely pancreas, and pancreatic duct dilation. He was diagnosed with traumatic intramural hematoma of the duodenum and treated by nasogastric suction and parenteral fluid administration. Percutaneous transhepatic gall bladder drainage (PTGBD) was done to decompress the bile and pancreatic ducts due to hematoma around the duodenal papilla. The patient's condition gradually improved and a CT scan 24 days after the accident showed the hematoma had resolved. PTGBD thus appears to be very useful in conservative by treating duodenal intramural hematoma associated with pancreatitis and cholecystitis.
