A concept of duodenal compartment syndrome: report of three cases of duodenal stenosis due to periduodenal hematoma.

Duodenal stenosis due to periduodenal hematoma is a rare condition. Although clinical presentations should vary among causes, symptoms of duodenal stenosis due to periduodenal hematoma commonly include abdominal pain, nausea, or vomiting. We describe three cases of duodenal stenosis due to periduodenal hematoma with similar clinical courses. All patients had mass-like hardness in the upper abdomen on physical examination and showed prolonged symptoms of duodenal stenosis given the usual time of hematoma resolution. On the basis of anatomic and embryologic background, hemorrhage presumably occurs in the duodenal compartment, which includes the distal part of the duodenum and its potential embryonic mesentery. Hematoma itself and the increased intracompartmental pressure result in distinctive clinical features, which suggest a concept of duodenal compartment syndrome.