Sonographic Diagnosis and Monitoring of an Obstructing Duodenal Hematoma After Blunt Trauma

Megremis, Stylianos; Segkos, Nikolaos; Andrianaki, Aikaterini; Gavridakis, G; Psillakis, Konstantinos; Triantafyllou, Lambros B.; Katsougris, Nikolaos; Michalakis, Michael; Sfakianaki, Evaggelia

doi:10.7863/jum.2004.23.12.1679

Cited by 15 publications

(9 citation statements)

References 14 publications

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“…In humans, the hematoma appears sonographically as a mass in the duodenal wall but the internal echotexture of the mass varies. Some were homogeneous and hypoechoic, while others had a heterogenous echogenicity 15−17 . It is not always possible to correctly diagnose a hematoma sonographically as it can appear similar to an abscess 18 .…”

Section: Discussionmentioning

confidence: 99%

Imaging Diagnosis-Spontaneous Intramural Canine Duodenal Hematoma

Heng

Huang

Baird

et al. 2010

Veterinary Radiology &Amp; Ultrasound

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A 9-year-old neutered female Pug with a 2-week history of pancreatitis was presented for dyspnea, icterus, and intractable vomiting. Sonographically, the gallbladder, intrahepatic bile ducts, and common bile duct were distended. The pancreas was hypoechoic with hyperechoic peripancreatic fat. A mildly heterogeneous intramural mass was present in the muscularis layer of the descending duodenum. A presumptive diagnosis of pancreatitis and smooth muscle tumor of the duodenum leading to common bile duct obstruction was made. The dog died despite supportive care. Necropsy examination confirmed the presence of pancreatitis and an intramural duodenal hematoma. r

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Section: Discussionmentioning

confidence: 99%

Imaging Diagnosis-Spontaneous Intramural Canine Duodenal Hematoma

Heng

Huang

Baird

et al. 2010

Veterinary Radiology &Amp; Ultrasound

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“…La ecografía nos permite observar la integridad duodenal y lesiones asociadas. Los signos más comunes son el signo de "doble burbuja" y el signo de la "vela de viento " (26,27) también tiene participación en el período prenata l, siendo el polihidramnios un signo sugestivo de obstrucción duodenal (28,29) Las membranas duodenales a su vez pueden ser hallazgos incidentales en el examen gastrointestinal con bario durante un TEGD. La retención de bario a nivel duodenal por más de 6 horas es sugestiva de su presencia (7)(8)(9).…”

Section: Discussionunclassified

Membranas Duodenales: Diagnósticos tardíos evidenciados por cuerpos extraños

Cevallos

Velarde

Dávila

et al. 2017

Pediatr

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Aceptado el 5 de octubre de 2016 Palabras clave:Membrana duodenal cuerpos extraños R E S U M E N Una de las causas de obstrucción duodenal congénita incompleta es la presencia de membranas duodenales, cuyo diagnóstico oportuno y preciso requiere un alto grado de sospecha.Presentamos dos casos de obstrucción duodenal con diagnóstico inicial de presencia de cuerpos extraños, razón por la cual los pacientes fueron sometidos a una intervención quirúrgica en la que se les encontraron membranas duodenales incompletas. La evolución clínica de estos pacientes tuvo un patrón distinto a lo esperado. Por esta razón, consideramos necesario abordar a este grupo de pacientes con un método multidisciplinar, distinto de aquel con que se procede en el caso de otros subtipos de obstrucciones duodenales. Duodenal Membranes: Late diagnoses evidenced by foreign bodies A B S T R A C TOne of the causes of congenital incomplete duodenal obstruction is the presence of duodenal membranes, which requires a high degree of suspicion for a timely and accurate diagnosis. We present two cases of duodenal obstruction with an initial diagnosis of foreign bodies, reason why the patients underwent a surgery in which incomplete duodenal membranes were detected. The clinical course of these patients displayed different patterns than expected. For this reason, we consider imperative to address this group of patients with a multidisciplinary method, different from that with which it is proceeded in the case of other subtypes of duodenal obstruction.

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“…1,2,4–10 The clotting profile should be checked as well to rule out any underlying coagulopathy. 1,8 …”

Section: Discussionmentioning

confidence: 99%

“…1,12,13,16 Most patients will recover within two weeks' time, and a follow-up CT scan of the abdomen will be useful for monitoring the resolution of the hematoma. 8,10 …”

Section: Discussionmentioning

confidence: 99%

An Unusual Cause of Intestinal Obstruction in an Adolescent: A Case Report

et al. 2009

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A 15-year-old boy presented with intestinal obstruction two weeks following a blunt abdominal trauma. He had progressive bilious vomiting without abdominal distension or peritonitis. The contrast computed tomography (CT) scan of the abdomen provided the definitive diagnosis: there was an obstructing duodenal hematoma, which might have been slowly progressing or have arisen from secondary hemorrhage after the initial injury. The boy remained stable over a ten-day period of conservative treatment, and his obstructive symptoms and signs were resolved completely. A follow-up CT scan of the abdomen (16 days after admission) showed an almost complete resolution of the hematoma. Delayed duodenal hematoma causing intestinal obstruction has been reported rarely in previous literature. Occasionally a significant secondary hemorrhage resulting in intestinal obstruction can become life threatening. Clinical follow-up is paramount after initial recovery. Although conservative treatment suffices in most cases, the surgeon should be wary of the need for definitive surgical intervention if there is evidence of ongoing acute hemorrhage or of the obstructing hematoma failing to resolve. Laparoscopic drainage of the hematoma provides optimistic results for patients failing conservative management.

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Sonographic Diagnosis and Monitoring of an Obstructing Duodenal Hematoma After Blunt Trauma

Cited by 15 publications

References 14 publications

Imaging Diagnosis-Spontaneous Intramural Canine Duodenal Hematoma

Imaging Diagnosis-Spontaneous Intramural Canine Duodenal Hematoma

Membranas Duodenales: Diagnósticos tardíos evidenciados por cuerpos extraños

An Unusual Cause of Intestinal Obstruction in an Adolescent: A Case Report

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