Eizaguirre I, Martínez-Mora J, Herrera M, Boix-Ochoa J, Martínez-Ibáñez V
An Esp Pediatr. 1982 Jan;16(1):53-9.
Six cases of intramural duodenal hematoma in children less than seven years old are presented. A review of the literature found 143 cases in patients under 15 years. The etiology is traumatic in most cases, although they have also been described in patients with Schönlein-Henoch purpura or coagulation diseases. Contrast X-rays are fundamental elements for diagnosis. The "spring" sign is very valuable. Patients were conservatively treated, although three of them where operated, one for a hepatic rupture and the two other for presumed appendicitis and intussusception respectively. In none was the hematoma drained. Clinical course was excellent and oral tolerance was achieved between three and seven days. Based on this experience and that obtained in the review of the literature, conservative treatment is recommended for intramural duodenal hematomas, when other associated problems needing a laparotomy have been excluded.
