What is a hematoma on the duodenum?
INTRODUCTION. Intramural hematoma is a rare duodenal injury, usually occurring in association with blunt abdominal trauma. It can result in partial or complete high intestinal obstruction often with a slow insidious onset leading to delay in diagnosis. Diagnosis and treatment remain controversial.
How is a duodenal hematoma treated?
A duodenal hematoma is treated with observation and parenteral hyperalimentation. Resolution generally occurs in 2 to 4 weeks. In some cases of duodenal hematoma, placement of a nasojejunal tube will allow enteral feeding distal to the point of obstruction.
What causes duodenal hematoma?
Duodenal hematoma results in hematoma formation in the duodenal wall. It may occur as a result of blunt abdominal trauma, non-accidental injury to children and spontaneously in anti-coagulated patients. Distinction must be made from duodenal perforation since the latter will require immediate surgical management.
How to diagnose duodenal hematoma?
Abdominal CT is the primary imaging modality for diagnosing intramural duodenal hematoma, with its characteristic findings including duodenal wall thickening, heterogeneous attenuation in the wall, periduodenal fluid, fluid in the pararenal space, and various degrees of obstruction [10].
Can a car accident cause pancreatitis?
Blunt trauma injuries to the pancreas are rare but are associated with significant overall mortality and a high complication rate. Motor vehicle collisions are the leading cause of blunt pancreatic trauma, followed by falls, and sports injuries.
Does the duodenum have a mesentery?
Except for the first segment, the rest of the duodenum is retroperitoneal and has no mesentery and is fixed to the posterior abdominal cavity.
What are the symptoms of an injured pancreas?
What are the signs and symptoms of blunt injuries to the pancreas?
- Abdominal pain that may be widespread or in the upper middle part of the abdomen.
- Bruising, swelling, or scratches over the injured area.
- Fever, nausea (upset stomach), or vomiting (throwing up).
- Trouble breathing.
Can pancreas injury make you tired?
Removing all or part of the pancreas may affect how well you can digest food, and you may need pancreatic enzymes to help with this. Having part of your pancreas removed may also cause diabetes. Eating less, problems with digestion and diabetes can all cause fatigue.
How long does it take to show signs of subdural hematoma?
Subdural hematoma. Signs and symptoms take time to develop, sometimes days or weeks after your injury. Chronic. The result of less severe head injuries, this type of hematoma can cause slow bleeding, and symptoms can take weeks and even months to appear. You might not recall injuring your head.
What are the signs and symptoms of intracranial hematoma?
However, with time, pressure on your brain increases, producing some or all of the following signs and symptoms: Loss of movement (paralysis) on the opposite side of the body from the head injury
Can a duodenum hematoma be a pancreatic injury?
Although characteristic of intramural duodenal hematoma, this finding is present in only approximately one-quarter of patients with hematoma. Although the initial treatment is nonoperative, associated injuries should be excluded, particularly pancreatic injury.
What to do if you find a duodenal hematoma?
If a duodenal hematoma is incidentally found at celiotomy, a thorough inspection must ensue to exclude perforation. This will require an extended Kocher maneuver, which usually successfully drains the subserosal hematoma.