A PEDIATRIC CASE OF TRAUMATIC INTRAMURAL HEMATOMA OF THE DUODENUM TREATED BY SURGERY

Abstract

　　The patient was an 11-year-old boy. He fell and was hit in the epigastrium by the stainless-steel canteen hanging from his neck. He developed epigastric pain and vomiting. At the hospital, he exhibited severe pressure pain and rebound tenderness in the epigastrium. Contrast-enhanced computed tomography revealed a high-density area in the descending portion of the duodenum and tears in the pancreatic head surrounded by fluid. He was diagnosed with traumatic intramural hematoma of the duodenum complicated by pancreatic injury. Laparotomy was performed because of marked peritoneal irritation and suspected pancreatic injury. The intramural hematoma of the duodenum was removed. He had a favorable postoperative course and was discharged on the 13th hospital day. If treatment is expected to be prolonged for traumatic intramural hematoma of the duodenum accompanied by severe abdominal symptoms or suspected concomitant injury of other organs, surgical treatment should be considered.