title: Acute pancreatitis secondary to intramural duodenal hematoma: Case report and literature review.
abstract: Nontraumatic intramural duodenal hematoma (IDH) is rare disease and it is generally related to coagulation abnormalities. Reports of nontraumatic IDH associated with pancreatic disease are relatively rare, and various conditions including acute or chronic pancreatitis are thought to be associated with nontraumatic IDH. However, the association between IDH and acute pancreatitis remains unknown. We report the case of a 45-year-old man who presented with vomiting and right hypochondrial pain. He had no medical history, but was a heavy drinker. The diagnosis of IDH was established by computed tomography, ultrasonography and endoscopy, and it was complicated by acute pancreatitis. The lesions resolved with conservative management. We discuss this case in the context of previously reported cases of IDH concomitant with acute pancreatitis. In our patient, acute pancreatitis occurred concurrently with hematoma, probably due to obstruction of the duodenal papilla, or compression of the pancreas caused by the hematoma. The present analysis of the published cases of IDH with acute pancreatitis provides some information on the pathogenesis of IDH and its relationship with acute pancreatitis.
authors.affiliation: Kazue Shiozawa, Manabu Watanabe, Yoshinori Igarashi, Yasushi Matsukiyo, Teppei Matsui, Yasukiyo Sumino, Department of Gastroenterology and Hepatology, Toho University Medical Center, Omori Hospital, 6-11-1, Omorinishi, Ota-ku, Tokyo 143-8541, Japan.
authors.forename: Kazue
authors.initials: K
authors.lastname: Shiozawa
authors.forename: Manabu
authors.initials: M
authors.lastname: Watanabe
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Igarashi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Matsukiyo
authors.forename: Teppei
authors.initials: T
authors.lastname: Matsui
authors.forename: Yasukiyo
authors.initials: Y
authors.lastname: Sumino