(CR23) A Rare Case of Delayed Presentation of Intestinal Obstruction Secondary to Intramural Duodenal Haematoma from Blunt Abdominal Trauma.

Introduction:

Intramural duodenal hematoma is a rare condition to occur following abdominal trauma and in the pediatric age group. The radiological distinction between duodenal hematoma and duodenal perforation is not always easy. This directly affects patient course of treatment as increased morbidity in delayed diagnosis and associated injuries. Intramural duodenal hematoma is usually treated conservatively. However, duodenal perforation needs urgent surgical intervention.

Case Report/Description:

We present a case of three years girl who had delayed presentation of duodenal hematoma and pancreatic injury who underwent surgery following conservative treatment and noted duodenal perforation intraoperatively.

Discussion/Conclusion:

Intramural duodenal haemorrhage is an acute condition, and early diagnosis can reduce possible complications. Complications include occlusion or stricture of the duodenum to pancreatitis, haemorrhage, and clinical shock. In young patients with blunt abdominal trauma and those presenting with abdominal pain who vomit bile and blood, intramural haemorrhage should be ruled out, particularly in anticoagulation treatment. In contrast to adult patients who can be examined by CT or MRI, young patients can be examined by ultrasound first. They may require additional imaging, i.e., fluoroscopy, CT, or MRI if ultrasound findings are inconclusive.