Esophagogastroduodenal pneumatosis with subsequent pneumoporta and intramural duodenal hematoma after endoscopic hemostasis: a case report

BMC Gastroenterology

Fat-Moon Suk²  Chih-Hsin Lee²  Wei-Cheng Huang¹ 

[1] Divisions of Gastroenterology, Wan Fang Hospital, Taipei Medical University, No. 111, Section 3, Hsing Long Road, Taipei 116, Taiwan;Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

关键词: Endoscopy;    Duodenum;    Hemostasis;    Intramural hematoma;    Pneumatosis intestinalis;   

Others  :  1234393
DOI  :  10.1186/s12876-015-0351-x

 received in 2015-05-29, accepted in 2015-09-21,  发布年份 2015

【 摘 要 】

Background

Esophagogastroduodenal pneumatosis is the presence of air in esophagus, stomach, and duodenum simultaneously, which have never been described in the literature. Intramural duodenal hematoma (IDH) rarely occurs after endoscopic intervention. The diagnosis and treatment in both conditions are great challenge in daily practice.

Case presentation

A 70-year-old male patient, who had been taking warfarin for artificial valve replacement, developed IDH and esophagogastroduodenal pneumatosis after endoscopic hemostasis for duodenal ulcer bleeding. Initially, he had abdominal pain, gastrointestinal bleeding and hypotension. Later, he was found to have acute pancreatitis, biliary obstruction, gastric outlet obstruction and rapid decline of hemoglobin also ensued. The intramural duodenal hematoma and critical condition resolved spontaneously after conservative medical treatment.

Conclusion

Based on this case report, we suggest that intramural duodenal hematoma should be considered if a patient has the tetrad of pancreatitis, biliary obstruction, gastric outlet obstruction and rapid decline of hemoglobin after an endoscopic intervention. Those patients could be treated conservatively. But, surgery should be considered if the diseases progress or complications persist.

【 授权许可】

   
2015 Huang et al.

【 图 表 】

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