title: Endoscopic drainage for duodenal hematoma following endoscopic retrograde cholangiopancreatography: a case report.
abstract: Intramural duodenal hematoma (IDH) is a rare complication following endoscopic retrograde cholangiopancreatography (ERCP). Blunt damage caused by the endoscope or an accessory has been suggested as the main reason for IDH. Surgical treatment of isolated duodenal hematoma after blunt trauma is traditionally reserved for rare cases of perforation or persistent symptoms despite conservative management. Typical clinical symptoms of IDH include abdominal pain and vomiting. Diagnosis of IDH can be confirmed by imaging techniques, such as magnetic resonance imaging or computed tomography and upper gastrointestinal endoscopy. Duodenal hematoma is mainly treated by drainage, which includes open surgery drainage and percutaneous transhepatic cholangial drainage, both causing great trauma. Here we present a case of massive IDH following ERCP, which was successfully managed by minimally invasive management: intranasal hematoma aspiration combined with needle knife opening under a duodenoscope.
authors.affiliation: Department of Endoscopy, Eastern Hepatobiliary Hospital, Second Military Medical University, Shanghai 200438, China.
authors.forename: Ya-Min
authors.initials: YM
authors.lastname: Pan
authors.forename: Tian-Tian
authors.initials: TT
authors.lastname: Wang
authors.forename: Jun
authors.initials: J
authors.lastname: Wu
authors.forename: Bing
authors.initials: B
authors.lastname: Hu
mesh_terms: D015746:Abdominal Pain; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D004322:Drainage / Q000379:methods*; D004378:Duodenal Diseases / Q000601:surgery*; D006406:Hematoma / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Duodenal hematoma; Duodenal obstruction; Endoscopic retrograde cholangiopancreatography; Non-operative method