Intramural duodenal hematoma after upper gastrointestinal endoscopy.
BACKGROUND
Intramural hematoma of the duodenum is a very rare condition. It is mostly seen after blunt abdominal trauma in children. There are only few cases of intramural duodenal hematoma after upper gastrointestinal endoscopy. Most of them are associated with coagulation disorders. The optimal treatment strategy for this condition is still under debate.


METHODS
We present the case of a 21-year-old woman who had undergone an upper gastrointestinal endoscopy for dyspepsia and protracted singultus. Work-up included biopsies. Immediately after the procedure, the patient developed an intramural hematoma causing complete duodenal obstruction. The patient was treated conservatively and recovered within three weeks without any sequelae.


CONCLUSIONS
Uncomplicated cases of intramural hematoma may be treated conservatively with total parenteral nutrition, fluid and electrolyte replacement.
Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria. katharina.hoenisch@gmail.com
Katharina
K
Hoenisch
Rupert
R
Prommegger
Hubert
H
Schwaighofer
Martin
M
Freund
Michael
M
Schocke
Wolfgang
W
Vogel
Arthur
A
Kaser
D015746:Abdominal Pain / Q000209:etiology*; D001706:Biopsy; D003937:Diagnosis, Differential; D004378:Duodenal Diseases / Q000175:diagnosis / Q000209:etiology*; D004380:Duodenal Obstruction / Q000175:diagnosis / Q000209:etiology*; D004415:Dyspepsia / Q000209:etiology*; D016145:Endoscopy, Digestive System / Q000009:adverse effects*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D006356:Heartburn / Q000209:etiology*; D006406:Hematoma / Q000175:diagnosis / Q000209:etiology*; D006606:Hiccup / Q000209:etiology*; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008279:Magnetic Resonance Imaging; D012075:Remission, Spontaneous; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D055815:Young Adult