Hoenisch Katharina, Prommegger Rupert, Schwaighofer Hubert, Freund Martin, Schocke Michael, Vogel Wolfgang, Kaser Arthur
Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
Wien Med Wochenschr. 2011 Sep;161(17-18):441-4. doi: 10.1007/s10354-011-0029-0.
Intramural hematoma of the duodenum is a very rare condition. It is mostly seen after blunt abdominal trauma in children. There are only few cases of intramural duodenal hematoma after upper gastrointestinal endoscopy. Most of them are associated with coagulation disorders. The optimal treatment strategy for this condition is still under debate.
We present the case of a 21-year-old woman who had undergone an upper gastrointestinal endoscopy for dyspepsia and protracted singultus. Work-up included biopsies. Immediately after the procedure, the patient developed an intramural hematoma causing complete duodenal obstruction. The patient was treated conservatively and recovered within three weeks without any sequelae.
Uncomplicated cases of intramural hematoma may be treated conservatively with total parenteral nutrition, fluid and electrolyte replacement.
十二指肠壁内血肿是一种非常罕见的病症。多见于儿童腹部钝性创伤后。上消化道内镜检查后发生十二指肠壁内血肿的病例很少。其中大多数与凝血障碍有关。这种病症的最佳治疗策略仍在争论中。
我们报告一例21岁女性病例，该患者因消化不良和持续性呃逆接受了上消化道内镜检查。检查包括活检。检查后不久，患者出现壁内血肿，导致十二指肠完全梗阻。患者接受了保守治疗，三周内康复，无任何后遗症。
无并发症的壁内血肿病例可通过全胃肠外营养、液体和电解质替代进行保守治疗。
