Spontaneous duodenal wall hematoma.
Víctor Echavarría RodríguezÁngela Antón RodríguezLuis Martín RamosJavier CrespoPublished in: Revista espanola de enfermedades digestivas (2023)
59-year-old man, smoker, diabetic and hypertensive. He went to the ER due to fixed abdominal pain in the epigastrium, diaphoresis, dizziness, nausea, and "coffee grounds" vomiting. On examination he presented abdominal distension and pain on palpation in the epigastrium, without peritonism. He had a BP of 235/100 mmHg and in the blood-tests, leukocytosis with neutrophilia and normal hemoglobin. An urgent abdominal CT scan was performed, identifying a 5x6 cm nodular lesion of homogeneous density attached to the wall of the second and third duodenal portions that compressed the lumen, with two vessels with active bleeding within it. Therefore, percutaneous embolization of the gastroduodenal artery was performed. Subsequently, the patient suffered an episode of severe acute pancreatitis that required ICU admission. Finally, he presented a good clinical evolution with ceasing of pain, complete reabsorption of the hematoma and resolution of the obstructive symptoms.
Keyphrases
- abdominal pain
- chronic pain
- computed tomography
- pain management
- neuropathic pain
- ultrasound guided
- emergency department
- blood pressure
- chemotherapy induced
- intensive care unit
- type diabetes
- minimally invasive
- case report
- early onset
- magnetic resonance imaging
- spinal cord injury
- single molecule
- sleep quality
- breast cancer cells
- physical activity
- endoplasmic reticulum