Five cases of traumatic intramural hematoma of the duodenum

Abstract

The occurence of intramural hematoma of the duodenum is relatively rare in Japan. The majority of these cases are due to blunt abdominal trauma, and have a high prevalence in children, because of their physical properties. We present here in five cases of traumatic intramural hematoma of the duodenum in children; three cases recovered with conservative therapy while the other two cases needed surgical therapy. All patients had abdominal pain and vomiting soon or a little after the trauma. Ultrasonography, upper Gl series, CT were useful to make the diagnosis or to distinguish the other associated injuries. In two cases, duodenal endoscopy was undertaken, which was useful for not only making the diagnosis but also being an aid of the conservative treatment. With recent progresses of intravenous hyperalimentation, non-operative therapy has been the first choice for the treatment of this condition. Howevere, surgical intervention should be considered in cases of failure of conservative therapy or in cases of supervening complications.