Clinical Gastroenterology Vol.15 No.9(8)

Theme Digestive Diseases to Know --Duodenum
Title Intramural Hematoma of the Duodenum
Publish Date 2000/08
Author Makoto Sawano Emergency and Life-Support Center, Bokutoh Tokyo Metropolitan Hospital
[ Summary ] Although intramural hematoma of the duodenum (IHD) is a rare cause of duodenal obstruction, there are some reported cases referring to IHD as a complication of endoscopic procedures. 70% of IHDs are classified as traumatic and are caused by blunt abdominal injury. In non-traumatic IHD cases, there is the idiopathic IHD type, seen in patients undergoing anti-co-agulant therapy, and also IHD seen in patients with acute pancreatitis, etc., as well as iatrogenic IHD seen as a complication of endoscopic procedures. Symptoms of upper gastro-intestinal obstruction (vomitting, stomach fulness) are often the only complaints from IHD patients. Most IHD cases are diagnosed by gastroduodenography and endoscopic findings. CT scans and USGs are also helpful in diagnosis of IHD. It is still controversial whether IHD should be treated conservatively or operatively, but in most reported cases conservative treatment has been the first choice.
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