Intramural duodenal hematoma in children: reappraisal of current management.

In children, intramural duodenal hematomas resulting from blunt abdominal trauma are generally managed nonoperatively with nasogastric suction and parenteral nutrition. Experience with three cases in which this form of treatment failed caused us to reappraise its benefits and results. Consequently, we now recommend surgical evacuation of intramural duodenal hematomas for children in whom there is no evidence of partial resolution of the obstruction after five days or of complete resolution after ten days of conservative management.