Case report: two cases of spontaneous intramural duodenal hematoma associated with pancreatitis

Lidija Ljubicic; Ivan Romic; Igor Petrovic; Zlatko Marusic; Hrvoje Silovski

doi:10.23750/abm.v93iS1.13041

Case report: two cases of spontaneous intramural duodenal hematoma associated with pancreatitis

Authors

Lidija Ljubicic a:1:{s:5:"en_US";s:35:"Department for Respiratory Diseases";}
Ivan Romic Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
Igor Petrovic Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
Zlatko Marusic Department of Pathology, University Hospital Centre Zagreb, Zagreb, Croatia
Hrvoje Silovski Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia

Keywords:

Pancreatitis, Duodenal hematoma, Computed tomography

Abstract

Intramural duodenal hematoma (IDH) is a rare entity and is generally associated with trauma. Spontaneous (nontraumatic) intramural duodenal hematoma is associated with bleeding disorders, anticoagulation therapy, alcoholism, pancreatitis, tumours and duodenal ulcers. We report two cases of spontaneous intramural duodenal hematoma in middle-aged men who subsequently developed pancreatitis. The underlying pathophysiology is still unclear. In the cases described, it is not clear whether the intramural duodenal hematoma contributed to the development of pancreatitis or pancreatitis has contributed to the development of IDH.

References

Hernandez-Jover D, Pernas JC, Gonzalez-Ceballos S, Lupu I, Monill JM, Pérez C. Pancreatoduodenal junction: review of anatomy and pathologic conditions. J Gastrointest Surg. 2011 Jul;15(7):1269-81.

Roseira J, Cunha M, Tavares de Sousa H, Rachadell J, Brito J. Delayed Intramural Duodenal Hematoma After a Simple Diagnostic Endoscopic Ultrasonography Fine-Needle Aspiration Procedure. ACG Case Rep J. 2019 Nov 25;6(11):e00279.

M’Lauchlan J. False aneurysm tumour occupying nearly the whole of the duodenum. Lancet. 1838;2:203–205.

Eurboonyanun C, Somsap K, Ruangwannasak S, Sripanaskul A. Spontaneous Intramural Duodenal Hematoma: Pancreatitis, Obstructive Jaundice, and Upper Intestinal Obstruction. Case Rep Surg. 2016;2016:5321081.

Aguilera F, Tsamalaidze L, Raimondo M, Puri R, Asbun HJ, Stauffer JA. Pancreaticoduodenectomy and Outcomes for Groove Pancreatitis. Dig Surg. 2018;35(6):475-81.

Shiozawa K, Watanabe M, Igarashi Y, Matsukiyo Y, Matsui T, Sumino Y. Acute pancreatitis secondary to intramural duodenal hematoma: Case report and literature review. World J Radiol. 2010;2(7):283-288.

Tezuka K, Makino T, Hirai I, Kimura W. Groove pancreatitis. Dig Surg. 2010;27(2):149-52. doi: 10.1159/000289099. Epub 2010 Jun 10.

Adsay NV, Zamboni G. Paraduodenal pancreatitis: a clinico-pathologically distinct entity unifying "cystic dystrophy of heterotopic pancreas", "para-duodenal wall cyst", and "groove pancreatitis". Semin Diagn Pathol. 2004 Nov;21(4):247-54.

DeSouza K, Nodit L. Groove pancreatitis: a brief review of a diagnostic challenge. Arch Pathol Lab Med. 2015 Mar;139(3):417-21. doi: 10.5858/arpa.2013-0597-RS. PMID: 25724040.

Goyal H, Singla U, Agrawal RR. A rare cause of acute pancreatitis: intramural duodenal hematoma. Case Rep Gastrointest Med. 2012;2012:275604.

Amankwa AT, De Graft-Johnson E, Twum KA, Ankomah K. A case of spontaneous intramural duodenal hematoma in a young African man: Imaging findings. Radiol Case Rep. 2021;16(7):1675-1678. Published 2021 Apr 30.

Kumar R, Athwal PSS, Kumar M, Devi K, Kahlon S. Spontaneous Intramural Duodenal Hematoma: A Rare Complication of Pancreatitis. Cureus. 2020;12(6):e8491. Published 2020 Jun 7.

Lee JY, Chung JS, Kim TH. Successful endoscopic decompression for intramural duodenal hematoma with gastric outlet obstruction complicating acute pancreatitis. Clin Endosc. 2012 Sep;45(3):202-4.