Duodenal hematoma in theadult: clinical imagingaspects. Presentation of three cases

Authors

  • Cristina de la Caridad Rivero-García Universidad de Ciencias Médicas de Camagüey. Hospital Universitario Manuel Ascunce Domenech. Servicio de Imagenología. Camagüey, Cuba. https://orcid.org/0000-0001-6911-5947
  • Eugenio Casola-Cortés Universidad de Ciencias Médicas de Camagüey. Hospital Universitario Manuel Ascunce Domenech. Servicio de Politrauma. Camagüey, Cuba. https://orcid.org/0000-0001-7170-6295
  • Mario Andrés Obando-Medina Universidad de Ciencias Médicas de Camagüey. Hospital Universitario Manuel Ascunce Domenech. Servicio de Imagenología. Camagüey, Cuba. https://orcid.org/0000-0003-4277-5675
  • Alden Hitesh Oneill-Gordon Universidad de Ciencias Médicas de Camagüey. Hospital Universitario Manuel Ascunce Domenech. Servicio de Imagenología. Camagüey, Cuba. https://orcid.org/0000-0003-1921-3623

Abstract

Background: the duodenal hematoma is an infrequent entity, usually of late diagnosis, which should be made according to risk factors, the clinical manifestations and imaging studies.
Objective: to show different clinical and imaging forms of presentation of duodenal hematoma according to type of imaging study and time of progress.
Cases reports: three cases of duodenal hematoma diagnosed in different follow up periods are presented. The history of the trauma was not recorded at the beginning in two cases neither considered as a predisposing factor, but the diagnostic research suspected the diagnosis. Vomiting and abdominal pain was seen in all three cases. Anemia, sub-jaundice dye and malaise were present at three months of follow up. Upper acute intestinal occlusive condition was secondary to endoscopic sclera-therapy due to digestive bleeding in the third case. Ultrasound, contrast radiography of the digestive tube and computerized axial tomography showed variations of the pattern depending on the modifications of the hematoma over time. Ultrasound as the first study detected the collection in all cases and was useful in the follow-up. Contrast radiological study was oriented towards the diagnosis and show predominance of regular patterns in case of late diagnosis. The Tomography achieved a greater diagnostic definition.
Conclusions: for the diagnosis of duodenal hematoma, it is necessary to take into account and think about risk factors, and the proper management of imaging studies in relation to time of progress. Tomography is the examination of choice.

DeCS: DUODENUM/injuries; HEMATOMA; CASE REPORTS; RISK FACTORS; DIAGNOSTIC IMAGING.

Downloads

Download data is not yet available.

Author Biography

Cristina de la Caridad Rivero-García, Universidad de Ciencias Médicas de Camagüey. Hospital Universitario Manuel Ascunce Domenech. Servicio de Imagenología. Camagüey, Cuba.

Especialista 2do grado en Radiiología

Profesora Auxiliar Consultante

Hospital Universitario ¨Manuel ascunce D.¨  Camaguey. Cuba

References

1. Asensio JA, Petrone P, García WM, Pardo M, García WM, Karsidag T. Manejo y revisión histórica de las lesiones duodenales. Rev Chil Cir [Internet]. Ago 2003 [citado 18 Jun 2019];55(4):[aprox. 8 p.]. Disponible en: https://www.cirujanosdechile.cl/revista_anteriores/PDF%20Cirujanos%202003_04/Rev.Cir.4.03.%2802%29.pdf

2. García Santos E, Soto Sánchez A, Verde JM, Marini CP, Asensio JA, Petrone P. Lesiones duodenales secundarias a traumatismo: revisión de la literatura. Cirugía Española [Internet]. Feb 2015 [citado 18 Jun 2019];93(2):[aprox. 11 p.]. Disponible en: http://www.elsevier.es/es-revista-cirugia-espanola-36-pdf-S0009739X1400270X

3. Irisarri Garde R, Vila Costas J. Hematoma duodenal tras esclerosis endoscópica. Rev esp enferm dig [Internet]. Sep 2017 [citado 26 Ago 2019];109(9). Disponible en: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082017000900012

4. Molina-Barea R, Pérez-Cabrera B, Hernández-García MD, Navarro-Freire F, Jiménez-Ríos JA. Abdomen agudo por hematoma duodenal intramural complicado. Cirugía y Cirujanos [Internet]. Mar-Abr 2015 [citado 18 Jun 2019];83(2):[aprox. 6 p.]. Disponible en: https://www.redalyc.org/pdf/662/66242704011_2.pdf

5. Elmoghazy W, Noaman I, Mahfouz AE, Elaffandi A, Khalaf H. Surgical management of complicated intra-mural duodenal hematoma: A case-report and review of literature. Int J Surg Case Rep [Internet]. 2015 [citado 18 Jun 2019];17:[aprox. 3 p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26595897/.

6. Ofori E, Sunkara T, Then E, John F, Gaduputi V. Acute duodenal intramural hematoma complicated by acute pancreatitis—a rare complication of endoscopic epinephrine injection therapy. Oxf Med Case Reports [Internet]. 2018 Ene [citado 19 Nov 2019];2018(1). Disponible en: https://pubmed.ncbi.nlm.nih.gov/29383264/.

7. Kim HS, Kim H, Kim WH, Hong SP, Cho JY. Huge Intramural Duodenal Hematoma Complicated with Obstructive Jaundice following Endoscopic Hemostasis. Korean J Gastroenterol [Internet]. 2019 Ene [citado 02 Nov 2019];73(1):[aprox. 6 p.]. Disponible en: https://www.kjg.or.kr/journal/view.html?uid=5408&vmd=Full

8. Orel SG, Nussbaum AR, Sheth S, Yale-Loehr A, Sanders RS. Duodenal Hematoma in Child Abuse. Sonographic detection. AJR Am J Roentgenol [Internet]. 1988 Jul [citado 02 Nov 2019];151(1):[aprox. 3 p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/3287864/.

9. Niehues SM, Denecke T, Bassir C, Hamm B, Haas M. Intramural duodenal hematoma: clinical course and imaging findings. Acta Radiol Open [Internet]. 2019 Abr [citado 22 Nov 2019];8(4). Disponible en: https://pubmed.ncbi.nlm.nih.gov/31007947/.

10. Elrouby A, Kotb M. Pediatric duodenal wall hematoma; an unexpected differential of an abdominal cyst. MOJ Clin Med Case Rep [Internet]. 2019 [citado 22 Nov 2019];9(1):[aprox. 3 p.]. Disponible en: http://www.medcraveonline.com/MOJCR/pediatric-duodenal-wall-hematoma-an-unexpected-differential-of-an-abdominal-cyst.html

11. Gopal P. Duodenal hematoma-Spectral CT [Internet]. 2019 Feb 24 [citado 22 Nov 2019]. Disponible en: https://www.ctspectral.com/spectral-cases/2019/2/24/doudenal hematoma

12. Builes Ramírez S, García Novoa MA, Fernández Soria N, Gómez Gutiérrez M. Trauma duodenal. Consecuencias del retraso en su diagnóstico: duodenal trauma. Cirugía Española [Internet]. Mar 2016 [citado 01 Nov 2019];94(3):[aprox. 2 p.]. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=5391180

Downloads

Published

2021-09-25

How to Cite

1.
Rivero-García C de la C, Casola-Cortés E, Obando-Medina MA, Oneill-Gordon AH. Duodenal hematoma in theadult: clinical imagingaspects. Presentation of three cases. Arch méd Camagüey [Internet]. 2021 Sep. 25 [cited 2025 Aug. 31];25(5):774-83. Available from: https://revistaamc.sld.cu/index.php/amc/article/view/7345

Issue

Vol. 25 No. 5 (2021)

Section

Case Reports

License

Copyright: Camagüey Medical Archive Magazine, offers immediately after being indexed in the SciELO Project; Open access to the full text of the articles under the principle of making available and free the research to promote the exchange of global knowledge and contribute to a greater extension, publication, evaluation and extensive use of the articles that can be used without purpose As long as reference is made to the primary source.

Conflicts of interest: authors must declare in a mandatory manner the presence or not of conflicts of interest in relation to the investigation presented.

(Download Statement of potential conflicts of interest)

The Revista Archivo Médico de Camagüey is under a License Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 International (CC BY 4.0).

This license allows others to distribute, to mix, to adjust and to build from its work, even for commercial purposes, as long as it is recognized the authorship of the original creation. This is the most helpful license offered. Recommended for maximum dissemination and use of licensed materials. The full license can be found at: https://creativecommons.org/licenses/