Korean J Nephrol.  2002 Jul;21(4):675-679.

Intramural Duodenal Hematoma Complicated with Pancreatitis after Endoscopic Hemostasis in a Chronic Renal Failure Patient with Maintenance Hemodialysis

• Lee SY
• Jo SK
• Park SM
• Seo JA
• Sung SA
• Han KH
• Cho WY
• Kim HK
• Jung SI

Abstract

Intramural duodenal hematoma is a rare finding in the adult, especially when related to iatrogenic complications of ulcer treatment, it can lead to biliary obstruction and pancreatitis, which can be fatal in severe case. We report one case of intramural duodenal hematoma complicated with pancreatitis after endoscopic hemostasis in a chronic renal failure patient with maintenance hemodialysis. He had a duodenal ulcer bleeding treated with endoscopic epinephrine injection and electro-coagulation therapy, but on the second day, he complained of persistent abdominal pain, nausea and vomiting. Abdominal ultrasound showed acute, edematous pancreatitis and a mass with low echodensity in the wall of the 2nd portion of the duodenum. Symptom and laboratory findings were persistent under conservative therapy, 7 days later, gastric resection, hematoma evacuation was carried out, subsequently the patient recovered from the pancreatitis but the patient died of septic shock and multiple organ dysfunction.

Keyword

Duodenal intramural hematoma; Pancreatitis; Chronic renal failure

MeSH Terms

Abdominal Pain
Adult
Duodenal Ulcer
Duodenum
Epinephrine
Hematoma*
Hemorrhage
Hemostasis, Endoscopic*
Humans
Kidney Failure, Chronic*
Nausea
Pancreatitis*
Renal Dialysis*
Shock, Septic
Ulcer
Ultrasonography
Vomiting
Epinephrine