Intramural Duodenal Hematoma with Acute Pancreatitis in a Patient With an Overt Pancreatic Malignancy

Khurana, Tanvi; Shah, Apeksha; Ali, Ijlal Akbar; Islam, Raafa; Siddiqui, Ali A.

doi:10.14309/crj.2014.55

Cited by 9 publications

(10 citation statements)

References 5 publications

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“…The most usual etiology is via trauma although it can also be related with endoscopic procedures, ulcer disease, or coagulation disorders (2). Few cases have been described in relation to acute pancreatitis (2)(3)(4). In that context it can occur as a result of the irritative effect of pancreatic enzymes on the vascular structures, as well as the compression of pancreatic necrosis and peripancreatic collections over adjacent structures (4).…”

Section: Discussionmentioning

confidence: 99%

Intramural gastric hematoma in the context of an acute pancreatitis

2017

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We present the case of a 47-year-old man that was admitted to the Department of Digestive Diseases due to epigastric abdominal pain, nausea, and vomiting over a three week period. Laboratory tests highlighted the presence of anemia (7 mg/dl) and elevated amylase (153 U/l), lipase (190 U/l), and PCR (100 mg/l). An abdominal ultrasound was performed in which gallstones were observed as well as a destructured pancreas with an adjacent large hyperdense collection. By means of an abdominal computerized tomography scan (CT) the presence of acute pancreatitis with necrosis at the level of the pancreatic head, peripancreatic collections, and a 12 cm hematoma at the level of the gastric wall were noted (Fig. 1). Conservative treatment was established with good clinical evolution. A follow-up CT two months later showed a decrease in the size of the hematoma. DiscussionIntramural hematomas of the gastrointestinal tract are an infrequent pathology. The majority of them occur in the duodenal wall, and a gastric location is less common (1). The most usual etiology is via trauma although it can also be related with endoscopic procedures, ulcer disease, or coagulation disorders (2). Few cases have been described in relation to acute pancreatitis (2-4). In that context it can occur as a result of the irritative effect of pancreatic enzymes on the vascular structures, as well as the compression of pancreatic necrosis and peripancreatic collections over adjacent structures (4).The management of these patients should be conservative in the absence of important active bleeding or other complications. Otherwise, vascular embolization by radiology is a safe and minimally invasive option, reserving surgery for selected cases (1).

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Section: Discussionmentioning

confidence: 99%

Intramural gastric hematoma in the context of an acute pancreatitis

2017

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“…Spontaneous intramural duodenal hematoma has been associated with coagulopathy, coagulating drugs, and endoscopic procedures [4–8]. However, there are many reports regarding intramural duodenal hematoma's association, with acute pancreatitis and pancreatic malignancy [9–13]. However, the association between intramural duodenal hematoma and acute pancreatitis is still unclear.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous Intramural Duodenal Hematoma: Pancreatitis, Obstructive Jaundice, and Upper Intestinal Obstruction

Eurboonyanun

Somsap

Ruangwannasak

et al. 2016

Case Reports in Surgery

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Nontraumatic intramural duodenal hematoma can cause upper gastrointestinal tract obstruction, upper gastrointestinal hemorrhage, jaundice, and pancreatitis and may be present in patients with normal coagulation. However the pathogenesis of the condition and its relationship with acute pancreatitis remain unknown. We present a case of spontaneous intramural duodenal hematoma and a case of successful nonoperative treatments.

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“…14 Conservative treatment is often performed, consisting of naso gastric tube, antibiotic therapy, volume support and parenteral nutrition. 7,12,15,16 When choosing conservative treatment, the patient should be monitored in order to diagnose possible complications, such as perforation and intestinal ischemia. 12 Surgical treatment is classified when the patient does not respond to conservative treatment, evolving with worsening of symptoms, increased hematoma, perforation or intestinal ischemia, and hematimetricl levels.…”

Section: Discussionmentioning

confidence: 99%

Duodenal hematoma secondary to acute chronic pancreatitis: case report and literature review

Souza¹,

Silva²,

Silva³

et al. 2019

MOJCR

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Introduction: Duodenal intramural hematoma is a rare consequence of pancreatitis, which occurs with obstruction of the duodenum, and may evolve with rupture of the organ. Case report: 47year-old male presenting abdominal pain and several episodes of vomiting. The upper gastrointestinal endoscopy and abdominal tomography confirmed the presence of duodenal intramural hematoma and pancreatitis. Conservative treatment was chosen, presenting a satisfactory response. However, it evolved with rupture of the hematoma and death. Discussion and Conclusion: duodenal intramural hematoma caused by pancreatitis is poorly reported in the literature, its treatment may be conservative or surgical, consideration should be given to the patient's clinical status and degree of duodenal involvement.

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Intramural Duodenal Hematoma with Acute Pancreatitis in a Patient With an Overt Pancreatic Malignancy

Cited by 9 publications

References 5 publications

Intramural gastric hematoma in the context of an acute pancreatitis

Intramural gastric hematoma in the context of an acute pancreatitis

Spontaneous Intramural Duodenal Hematoma: Pancreatitis, Obstructive Jaundice, and Upper Intestinal Obstruction

Duodenal hematoma secondary to acute chronic pancreatitis: case report and literature review

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