Aizawa K, Tokuyama H, Yonezawa T, Doi M, Matsuzono Y, Matumoto M, Uragami K, Nishioka S, Yataka I
Department of Internal Medicine, Hashimoto Municipal Hospital, Wakayama, Japan.
Gastroenterol Jpn. 1991 Apr;26(2):218-23. doi: 10.1007/BF02811084.
A 52-year-old man was admitted on February 15, 1990, with hiccups and vomiting. He had been well until 13 days before admission when he stumbled and fell when intoxicated, striking his abdomen. A diagnosis of intramural hematoma was made with computerized tomography and sonography of the abdomen after admission, revealing a mass that was intimately related to the duodenum. Treatment of the intramural duodenal hematoma is controversial. However, this case illustrates the ideal situation where conservative management could be applied with total parenteral nutrition, percutaneous aspiration drainage, and endoscopic balloon catheter dilatation of the narrowed lumen of the duodenum. The patient's subsequent course supports the concept of planned conservative management.
