Korean J Gastroenterol.  2019 Jan;73(1):39-44. 10.4166/kjg.2019.73.1.39.

Huge Intramural Duodenal Hematoma Complicated with Obstructive Jaundice following Endoscopic Hemostasis

• Kim HS
• Kim HK
• Kim WH
• Hong SP
• Cho JY

• KMID: 2432435
• DOI: http://doi.org/10.4166/kjg.2019.73.1.39

Abstract

Intramural hematoma of the duodenum is a relatively unusual complication associated with the endoscopic treatment of bleeding peptic ulcers. Intramural hematomas are typically resolved spontaneously with conservative treatment alone. We report a case of an intramural duodenal hematoma following endoscopic hemostasis with epinephrine injection therapy, which was associated with transient obstructive jaundice in a patient undergoing hemodialysis. The patient developed biliary sepsis due to obstruction of the common bile duct secondary to the huge hematoma. He was treated with fluoroscopy-guided drainage catheter insertion, which spontaneously resolved the biliary sepsis through conservative treatment in 6 weeks. Fluoroscopy-guided drainage may impact the treatment of intramural hematomas that involve life-threatening complications.

Keyword

Duodenal ulcer; Hematoma; Cholestasis; Drainage

MeSH Terms

Catheters
Cholestasis
Common Bile Duct
Drainage
Duodenal Ulcer
Duodenum
Epinephrine
Hematoma*
Hemorrhage
Hemostasis, Endoscopic*
Humans
Jaundice, Obstructive*
Peptic Ulcer
Renal Dialysis
Sepsis
Epinephrine