title: Conservative management of intestinal obstruction by isolated intramural duodenal hematoma. A case report and review of the literature.
abstract: The duodenal injuries occur in the 3-5% of blunt abdominal traumas. The isolated intramural duodenal hematoma is a very rare lesion. An early diagnosis and an adequate therapy are crucial because a delay, beyond 24 hours, increases the mortality from the 11% to 40%. However, diagnosis is often hindered by a lack of specific symptoms. We report a case of a 21 years-old man with an intestinal obstruction from isolated intramural duodenal hematoma occurred after a blunt abdominal trauma in a sport competition. The patient was treated conservatively with total parenteral nutrition, gastric decompression and intravenous PPIs. The progressive spontaneous resolution of the hematoma was checked with periodical endoscopies. The discharge occurred after three weeks with no early complications. No late complications occurred at one-year follow-up. The endoscopy is a good and safe tool in the management of this intestinal obstructions with the possibility of conservative or interventional treatment.
authors.forename: Francesco
authors.initials: F
authors.lastname: D'Arpa
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Orlando
authors.forename: Roberta
authors.initials: R
authors.lastname: Tutino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Salamone
authors.forename: Emanuele Onofrio
authors.initials: EO
authors.lastname: Battaglia
authors.forename: Gaspare
authors.initials: G
authors.lastname: Gulotta
mesh_terms: D000007:Abdominal Injuries / Q000150:complications*; D000328:Adult; D000072700:Conservative Treatment / Q000379:methods; D004359:Drug Therapy, Combination; D004378:Duodenal Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D042241:Early Diagnosis; D016145:Endoscopy, Digestive System / Q000379:methods; D019160:Endosonography / Q000379:methods; D005765:Gastrointestinal Agents / Q000008:administration & dosage*; D006406:Hematoma / Q000150:complications* / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D008297:Male; D010288:Parenteral Nutrition / Q000379:methods; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D005765:Gastrointestinal Agents; D054328:Proton Pump Inhibitors