Sonographic characteristics of intramural bowel hematoma

“…[8][9][10] CT is the imaging modality of choice in the diagnosis of duodenal hematoma, and CT finding of hyperdense circumferential wall thickening is pathognomonic of intramural hematoma. 11 Within 10 days, the hyperdensity of the bowel wall tends to decrease due to evolution of the hematoma into a hypodense area then mimic an intramural cystic lesion. CT can be complemented with sonography and barium meal study.…”

Section: Discussionmentioning

confidence: 99%

Sonographic diagnosis and monitoring of an intramural duodenal hematoma following upper endoscopic biopsy in a child

Zarifi

Gentimi

Christopoulos-Geroulanos

2009

J of Clinical Ultrasound

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Intramural duodenal hematoma is an uncommon complication of pediatric endoscopic biopsy that occurs mainly in children with bleeding disorders. We report the case of a 5-year-old girl who presented with signs of partial duodenal obstruction and acute pancreatitis due to duodenal hematoma following endoscopic biopsy. The lesion was diagnosed and monitored by sonography and resolved with conservative management.

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“…2 Abdominal computed tomography scan may reveal long symmetric bowel wall thickening with hyperdense material, sometimes referred to as "stack-of-coins," "pseudo-kidney," or "coiled spring" signs. 3 Treatment is usually conservative with correction of the coagulopathy.…”

Section: Answer To: Image 4 (Page 831): Spontaneous Intramural Hematomentioning

confidence: 99%

Unusual Cause of Abdominal Pain

Yen

2016

Gastroenterology

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Question: A 77-year-old man with atrial fibrillation presented to the emergency department with abdominal pain that had worsened over the course of 1 day. The patient had suffered a similar attack 6 months earlier and was diagnosed with mesenteric ischemia. He had received anticoagulant therapy since this first attack. Physical examination revealed mild pale conjunctiva, hypoactive bowel sounds, and mild muscle guarding over the lower abdomen without bleeding. Laboratory analysis revealed normal liver and renal function. The white blood cell count was well within the normal range, and the patient had mild anemia (hemoglobin, 10.2 g/dL). A bedside abdominal ultrasound was performed (Figure A, Video 1). Further assessment of the coagulation profile revealed a prothrombin time of >160 s (normal, 9.9-12). An abdominal computed tomography examination was subsequently performed (Figure B). What is the finding of abdominal ultrasound? What is the finding of abdominal computed tomography? Look on page 832 for the answer and see the Gastroenterology web site (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and Images in GI.

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Sonographic characteristics of intramural bowel hematoma

Cited by 11 publications

References 4 publications

Spontaneous intramural small-bowel hematoma secondary to anticoagulant therapy: a case series

Spontaneous intramural small-bowel hematoma secondary to anticoagulant therapy: a case series

Sonographic diagnosis and monitoring of an intramural duodenal hematoma following upper endoscopic biopsy in a child

Unusual Cause of Abdominal Pain

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