title: Delayed duodenal obstruction after intramural hematoma in a patient with paroxysmal nocturnal hemoglobinuria: A case report.
abstract: BACKGROUND
  Paroxysmal nocturnal hemoglobinuria (PNH) is a clonal stem cell disorder of hematopoietic cells. Gastrointestinal complications of PNH are rare and mostly related with intravascular thrombosis or intramural hematoma.
  
  
  METHODS
  We describe a case of a man with PNH complicated by intramural duodenal hematoma initially treated with supportive care. Three months after his first admission; he was admitted to the emergency department with abdominal pain, nausea and vomiting. He had undergone to surgery because of duodenal obstruction was treated with duodenojejunal by-pass surgery.
  
  
  CONCLUSIONS
  Patients were healed from gastrointestinal complications could suffer from gastrointestinal strictures, which cause wide spread symptoms ranging from chronic abdominal pain and anorexia to intestinal obstruction.
  
  
  CONCLUSIONS
  We report a rare intestinal obstruction case caused by stricture at the level of ligamentum Treitz with PNH. The possibility simply has to be borne in mind that strictures can be occurring at hematoma, ischemia or inflammation site of gastrointestinal tract.
authors.affiliation: Department of General Surgery, Başkent University School of Medicine, Ankara Hospital, Turkey. Electronic address: tugant@baskent-ank.edu.tr.
authors.forename: Tugan
authors.initials: T
authors.lastname: Tezcaner
authors.affiliation: Department of General Surgery, Başkent University School of Medicine, Ankara Hospital, Turkey.
authors.forename: Yahya
authors.initials: Y
authors.lastname: Ekici
authors.affiliation: Department of General Surgery, Başkent University School of Medicine, Ankara Hospital, Turkey.
authors.forename: Mahir
authors.initials: M
authors.lastname: Kırnap
authors.affiliation: Department of General Radiology, Başkent University School of Medicine, Ankara Hospital, Turkey.
authors.forename: Feride
authors.initials: F
authors.lastname: Kural
authors.affiliation: Department of General Surgery, Başkent University School of Medicine, Ankara Hospital, Turkey.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Moray
keywords: Intestinal obstruction; Paroxysmal nocturnal hemoglobinuria