Kwon Chang-Il, Choi Ki Hyun, Ko Eun Hyang, Lee Ji Hyun, Song Young Jun, Ko Kwang Hyun, Hong Sung Pyo, Park Pil Won
Department of Internal Medicine, Bundang CHA General Hospital, College of Medicine, Pochon CHA University, Seongnam, Korea.
Korean J Gastroenterol. 2007 Jan;49(1):45-9.
Complicating intramural hematoma is an interesting, relatively unusual condition. Various etiologic factors have been described, with the most common being blunt trauma, anticoagulant therapy, Henoch-Sch nlein purpura and blood dyscrasias. Most intramural hematomas resolve spontaneously with conservative treatment, and the prognosis is good. However, if the abdominal pain or obstruction does not resolve with medical management over seven to ten days, complications such as infarction or peritonitis may occur, and surgical intervention might be required. We report a case of intramural hematoma of duodenum treated with percutaneous drainage and embolization of bleeding focus which was complicated with acute pancreatitis after anticoagulation treatment in a patient with recurrent history of deep vein thrombosis. In addition, we reviewed reports of intramural hematoma of the duodenum and treatment strategies.
壁内血肿是一种有趣但相对不常见的病症。已描述了多种病因,最常见的是钝性创伤、抗凝治疗、过敏性紫癜和血液系统疾病。大多数壁内血肿通过保守治疗可自行消退,预后良好。然而,如果腹痛或梗阻在7至10天的药物治疗后仍未缓解,可能会发生梗死或腹膜炎等并发症,可能需要手术干预。我们报告了1例十二指肠壁内血肿患者,该患者有复发性深静脉血栓形成病史,在抗凝治疗后并发急性胰腺炎,采用经皮引流和出血灶栓塞治疗。此外,我们回顾了十二指肠壁内血肿的报告及治疗策略。