Gastroenterology and Endoscopy Unit, Ospedale G. Mazzini, Teramo 64100, Italy.
Gastroenterology and Endoscopy Unit, AORN San Giuseppe Moscati, Avellino 83100, Italy.
World J Gastroenterol. 2022 May 28;28(20):2243-2247. doi: 10.3748/wjg.v28.i20.2243.
Intramural duodenal hematoma is a rare condition described for the first time in 1838. This condition is usually associated with blunt abdominal trauma in children. Other non-traumatic risk factors for spontaneous duodenal haematoma include several pancreatic diseases, coagulation disorders, malignancy, collagenosis, peptic ulcers, vasculitis and upper endoscopy procedures. In adults the most common risk factor reported is anticoagulation therapy. The clinical presentation may vary from mild abdominal pain to acute abdomen and intestinal obstruction or gastrointestinal bleeding.
The aim of this case summary is to show a case of intramural spontaneous hematoma with symptoms of intestinal obstruction that was properly drained endoscopically by an innovative system lumen-apposing metal stent Hot AXIOS™ stent (Boston Scientific Corp., Marlborough, MA, United States).
Endoscopic lumen-apposing metal stent Hot AXIOS™ stent is a safe and feasible treatment of duodenal intramural hematoma in our case.
肠壁血肿是一种罕见的病症，于 1838 年首次描述。这种病症通常与儿童钝性腹部创伤有关。自发性十二指肠血肿的其他非创伤性危险因素包括多种胰腺疾病、凝血障碍、恶性肿瘤、胶原病、消化性溃疡、脉管炎和上消化道内镜检查。在成年人中，最常见的危险因素是抗凝治疗。临床表现从轻度腹痛到急性腹痛、肠梗阻或胃肠道出血不等。
本病例总结的目的是展示一例以肠梗阻为主要症状的自发性肠壁血肿，采用创新的内腔贴合金属支架 Hot AXIOS™支架（波士顿科学公司，马萨诸塞州马尔伯勒，美国）进行了内镜下适当引流。
在我们的病例中，内镜下内腔贴合金属支架 Hot AXIOS™支架是一种安全可行的治疗十二指肠壁内血肿的方法。
