Spontaneous intramural duodenal hematoma in type 2B von Willebrand disease
Intramural duodenal hematoma is a rare cause of a proximal gastrointestinal tract obstruction. Presentation of intramural duodenal hematoma most often occurs following blunt abdominal trauma in children, but spontaneous non-traumatic cases have been linked to anticoagulant therapy, pancreatitis, mal...
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Published in | World journal of gastroenterology : WJG Vol. 19; no. 41; pp. 7205 - 7208 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Baishideng Publishing Group Co., Limited
07.11.2013
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Subjects | |
Online Access | Get full text |
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Summary: | Intramural duodenal hematoma is a rare cause of a proximal gastrointestinal tract obstruction. Presentation of intramural duodenal hematoma most often occurs following blunt abdominal trauma in children, but spontaneous non-traumatic cases have been linked to anticoagulant therapy, pancreatitis, malignancy, vasculitis and endoscopy. We report an unusual case of spontaneous intramural duodenal hematoma presenting as an intestinal obstruction associated with acute pancreatitis in a patient with established von Willebrand disease, type 2B. The patient presented with abrupt onset of abdominal pain, nausea, and vomiting. Computed tomography imaging identified an intramural duodenal mass consistent with blood measuring 4.7 cm × 8.7 cm in the second portion of the duodenum abutting on the head of the pancreas. Serum lipase was 3828 units/L. Patient was managed conservatively with bowel rest, continuous nasogastric decompression, total parenteral nutrition, recombinant factor VIII (humateP) and transfusion. Symptoms resolved over the course of the hospitalization. This case highlights an important complication of an inherited coagulopathy. |
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Bibliography: | ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3 Author contributions: Eichele DD, Ross M and Tang P all contributed to drafting the article and revision of intellectual content; Hutchins GF and Mailliard M both contributed to critical revision of intellectual content; all authors provided final approval to the submitted version of the article. Correspondence to: Derrick D Eichele, MD, Division of General Internal Medicine, University of Nebraska Medical Center, 985185 Nebraska Medical Center, Omaha, NE 68198-5185, United States. derrick.eichele@unmc.edu Telephone: +1-402-7094309 Fax: +1-402-5599385 |
ISSN: | 1007-9327 2219-2840 |
DOI: | 10.3748/wjg.v19.i41.7205 |