Ma Julius K, Ng Kelvin K, Poon Ronnie T, Fan Sheung Tat
Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR.
Asian J Surg. 2008 Apr;31(2):83-6. doi: 10.1016/S1015-9584(08)60063-9.
Spontaneous intramural duodenal haematoma (IDH) is an uncommon pathology and it is usually related to anticoagulant therapy. Other causes include various pancreatic diseases, connective tissue disease, peptic ulcer disease and pancreaticoduodenal aneurysm. IDH of pancreatic origin has been infrequently reported. The disease course can be life-threatening and serious complications may occur, including gastric outlet obstruction, duodenal perforation and septicaemia. A case of pancreatic-induced IDH is presented, for which pancreaticoduodenectomy was performed as definitive treatment. In general, medical treatment with continuous nasogastric aspiration and total parenteral nutrition is recommended as initial management strategy. Surgical interventions (evacuation of blood clot or surgical resection) are reserved for patients in whom medical treatment fails or complications occur.
自发性十二指肠壁内血肿（IDH）是一种罕见的病症，通常与抗凝治疗有关。其他病因包括各种胰腺疾病、结缔组织病、消化性溃疡病和胰十二指肠动脉瘤。胰腺源性IDH的报道较少。该病病程可能危及生命，可能会出现严重并发症，包括胃出口梗阻、十二指肠穿孔和败血症。本文介绍了一例胰腺引起的IDH病例，对其进行了胰十二指肠切除术作为确定性治疗。一般而言，建议采用持续鼻胃吸引和全胃肠外营养的药物治疗作为初始管理策略。手术干预（清除血凝块或手术切除）适用于药物治疗失败或出现并发症的患者。
