Iatrogenic intramural hematoma of the duodenum caused by endoscopic therapy of bleeding peptic ulcer. A case report

Abstract

The authors report a case of intestinal obstruction resulting from a duodenal intramural hematoma after therapeutic upper digestive endoscopy with injection therapy. Intramural duodenal hematomas are rare clinical entities, mostly caused by blunt traumas. They may also, more rarely, be due to complications of peptic duodenal ulcers, or be the iatrogenic result of an endoscopic biopsy or placement of a percutaneous endoscopic gastrostomy catheter. It has recently become obvious that surgery is not necessary in most patients with duodenal hematomas. The treatment of choice for cases of intramural duodenal hematomas is of a conservative kind. Today we can employ minimally invasive diagnostic and therapeutic techniques for the percutaneous or laparoscopic evacuation of the hematoma, which seem to guarantee optimal results, compared to the high morbidity rate associated with laparatomy evacuation.