Year 2024 / Volume 116 / Number 4
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Spontaneous duodenal wall hematoma

218-219

DOI: 10.17235/reed.2023.9793/2023

Víctor Echavarría Rodríguez, Ángela Antón Rodríguez, Luis Martín Ramos, Javier Crespo,

Abstract
59-year-old man, smoker, diabetic and hypertensive. He went to the ER due to fixed abdominal pain in the epigastrium, diaphoresis, dizziness, nausea, and "coffee grounds" vomiting. On examination he presented abdominal distension and pain on palpation in the epigastrium, without peritonism. He had a BP of 235/100 mmHg and in the blood-tests, leukocytosis with neutrophilia and normal hemoglobin. An urgent abdominal CT scan was performed, identifying a 5x6 cm nodular lesion of homogeneous density attached to the wall of the second and third duodenal portions that compressed the lumen, with two vessels with active bleeding within it. Therefore, percutaneous embolization of the gastroduodenal artery was performed. Subsequently, the patient suffered an episode of severe acute pancreatitis that required ICU admission. Finally, he presented a good clinical evolution with ceasing of pain, complete reabsorption of the hematoma and resolution of the obstructive symptoms.
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References
Kang EA, Han SJ, Chun J, Lee HJ, Chung H, Im JP, Kim SG, Kim JS, Yoon H, Shin CM, Park YS, Kim N, Lee DH, Jung HC. Clinical features and outcomes in spontaneous intramural small bowel hematoma: Cohort study and literature review. Intest Res. 2019 Jan;17(1):135-143. doi: 10.5217/ir.2018.000
Gil Rojas S, Estela Villa LM, Jiménez Vicente EM. Spontaneous intramural small-bowel hematoma: a cause of acute abdomen in anticoagulated patients. Rev Esp Enferm Dig. 2022 Mar;114(3):184-185. doi: 10.17235/reed.2021.7640/2020.
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Echavarría Rodríguez V, Antón Rodríguez Á, Martín Ramos L, Crespo J. Spontaneous duodenal wall hematoma. 9793/2023


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Publication history

Received: 21/06/2023

Accepted: 18/07/2023

Online First: 14/09/2023

Published: 09/04/2024

Article Online First time: 85 days

Article editing time: 293 days


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