Intramural duodenal hematoma secondary to pancreatitis

case report and review of the literature

Authors

  • João Henrique Botto de Oliveira Centro Médico de Campinas
  • Raiza Samenica Esper Centro Médico de Campinas
  • Rodrigo Campos Ocariz Centro Médico de Campinas
  • Flora Specian Sartori Centro Médico de Campinas
  • Lucas Marcelo Dias Freire Centro Médico de Campinas
  • Elinton Adami Chaim Centro Médico de Campinas
  • Francisco Callejas-Neto Centro Médico de Campinas
  • Everton Cazzo Centro Médico de Campinas

Keywords:

Pancreatitis, Duodenum, Hematoma, Embolization, therapeutic, Duodenal diseases

Abstract

CONTEXT: Spontaneous intramural duodenal hematoma is uncommon and is usually associated with coagulopathy, anticoagulant therapy and endoscopic procedures. The aim here was to describe a case of intramural duodenal hematoma caused by chronic exacerbation of pancreatitis. CASE REPORT: A 46-year-old male with chronic alcoholic pancreatitis was admitted to hospital due to abdominal pain, melena and low hemoglobin. An intramural duodenal hematoma with active bleeding was detected and selective angioembolization was warranted. The patient evolved with a perforated duo- denum and underwent laparotomy with exclusion of the pylorus and Roux-en-Y gastrojejunostomy. He was discharged nine days later. CONCLUSION: Intramural duodenal hematoma is a rare complication of pancreatitis. Selective emboliza- tion is the preferred treatment for hemorrhagic complications of pancreatitis. However, the risk of visceral ischemia and perforation should be considered.

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Author Biographies

João Henrique Botto de Oliveira, Centro Médico de Campinas

MD. Resident Physician, Department of Surgery, Centro Médico de Campinas (CMC), Campinas (SP), Brazil.

Raiza Samenica Esper, Centro Médico de Campinas

MD. Resident Physician, Department of Surgery, Centro Médico de Campinas (CMC), Campinas (SP), Brazil.

Rodrigo Campos Ocariz, Centro Médico de Campinas

MD. Resident Physician, Department of Surgery, Centro Médico de Campinas (CMC), Campinas (SP), Brazil.

Flora Specian Sartori, Centro Médico de Campinas

MD. Resident Physician, Department of Surgery, Centro Médico de Campinas (CMC), Campinas (SP), Brazil.

Lucas Marcelo Dias Freire, Centro Médico de Campinas

MD, PhD. Full Professor, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM/UNICAMP), Campinas (SP), Brazil.

Elinton Adami Chaim, Centro Médico de Campinas

MD, PhD. Full Professor, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM/UNICAMP), Campinas (SP), Brazil.

Francisco Callejas-Neto, Centro Médico de Campinas

MD, MSc. Assistant Professor, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM/ UNICAMP), Campinas (SP), Brazil.

Everton Cazzo, Centro Médico de Campinas

MD, PhD. Adjunct Professor, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM/ UNICAMP), Campinas (SP), Brazil.

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Published

2018-12-06

How to Cite

1.
Oliveira JHB de, Esper RS, Ocariz RC, Sartori FS, Freire LMD, Chaim EA, Callejas-Neto F, Cazzo E. Intramural duodenal hematoma secondary to pancreatitis: case report and review of the literature. Sao Paulo Med J [Internet]. 2018 Dec. 6 [cited 2025 Mar. 9];136(6):597-601. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/619

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Section

Case Report