Laparoscopic drainage of an intramural duodenal haematoma: a novel technique and review of the literature

Abstract

Intramural Duodenal Haematoma (IDH) is an uncommon complication of blunt abdominal trauma. IDH's are most often treated non-operatively. We describe laparoscopic treatment of an IDH after failed conservative management. To our knowledge, successful laparoscopic drainage of an IDH in an adult has not been described previously in the literature.

A Rare Case of Gastric Outlet Obstruction due to Large Intramural Duodenal Hematoma Following Endotherapy for Bleeding Duodenal Ulcer in a Patient with End-stage Renal Disease

“…When conservative treatment is not effective, other modalities such as surgical drainage (laparotomy, laparoscopic drainage), ultrasound-or CT-guided drainage are used. [16] In addition, endoscopic incision and drainage techniques are also used in the treatment as a more comfortable method. [17] In our case, as there was no emergent indication for any invasive treatment such as sepsis, signs of peritonism, obstructive jaundice, or pancreatitis due to pressure over the ampulla or continued bleeding so a decision to manage the patient conservatively was taken.…”

A Lethal Complication of Endoscopic Therapy: Duodenal Intramural Hematoma

“…Treatment of DIHs is usually conservative and recovery with conservative treatment has been shown especially in childhood and in cases with gastric outlet obstruction [ 9 ]. When conservative treatment is not effective, surgical drainage choices of ultrasound- or CT-guided drainage (laparotomy, laparoscopic drainage) are used [ 10 ]. Additionally, endoscopic incision and drainage techniques are used in the treatment as a more comfortable method [ 11 ].…”

A curious case of spontaneous duodenal haematoma presenting a diagnostic challenge

“…The mainstay strategy for treatment is conservative management if the patient is stable 11. In the past, surgical evacuation of the haematoma would occasionally be performed if no improvement is observed in 7–14 days 2–4 11.…”

“…In the past, surgical evacuation of the haematoma would occasionally be performed if no improvement is observed in 7–14 days 2–4 11. However, in the past decade, this style of management seems to be going out of vogue as guided percutaneous aspirations are proving to be highly effective, with at least four successful cases reported in recent years 2.…”