期刊论文详细信息
BMC Gastroenterology
Esophagogastroduodenal pneumatosis with subsequent pneumoporta and intramural duodenal hematoma after endoscopic hemostasis: a case report
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
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【 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.

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【 参考文献 】
  • [1]St Peter SD, Abbas MA, Kelly KA: The spectrum of pneumatosis intestinalis. Arch Surg 2003, 138:68-75.
  • [2]Hameed S, McHugh K, Shah N, Arthurs OJ: Duodenal haematoma following endoscopy as a marker of coagulopathy. Pediatr Radiol 2014, 44:392-7.
  • [3]Zenooz NA, Robbin MR, Perez V: Gastric pneumatosis following nasogastric tube placement: a case report with literature review. Emerg Radiol 2007, 13:205-7.
  • [4]Chelimilla H, Makker JS, Dev A: Incidental finding of esophageal pneumatosis. World J Gastrointest Endosc 2013, 5:74-8.
  • [5]Chung YF, Koo WH: Gastric pneumatosis after endoscopic argon plasma coagulation. Ann Acad Med Singapore 2005, 34:569-70.
  • [6]Domínguez Jiménez JL, Puente Gutiérrez JJ, Marín Moreno MA, Bernal Blanco E, Gallardo Camacho JI, Uceda VA: Gastric pneumatosis and gas in the portal venous system secondary to peptic ulcer. Gastroenterol Hepatol 2008, 31:494-6.
  • [7]Mclaughlin SA, Nguyen JH: Conservative management of nongangrenous esophageal and gastric pneumatosis. Am Surg 2007, 73:862-4.
  • [8]Heng Y, Schuffler MD, Haggitt RC, Rohrmann CA: Pneumatosis intestinalis: a review. Am J Gastroenterol 1995, 90:1747-58.
  • [9]Jones WR, Hardin WJ, Davis JT, Hardy JD: Intramural hematoma of the duodenum: a review of the literature and case report. Ann Surg 1971, 173:534-44.
  • [10]Sugai K, Kajiwara E, Mochizuki Y, Noma E, Nakashima J, Uchimura K, Sadoshima S: Intramural duodenal hematoma after endoscopic therapy for a bleeding duodenal ulcer in a patient with liver cirrhosis. Intern Med 2005, 44:954-7.
  • [11]Chung S, Park CW, Chung HW, Shin SJ, Chang YS: Intramural duodenal hematoma and hemoperitoneum after endoscopic treatment in a patient with chronic renal failure on hemodialysis: a case report. Cases J 2009, 2:9083. BioMed Central Full Text
  • [12]Thandassery RB, John A, Koshy RM, Kaabi SA. Endoscopy. 2014;46 Suppl 1. Unusual Cases and Technical Notes (UCTN): E443-444.
  • [13]Jewett TC Jr, Caldarola V, Karp MP, Allen JE, Cooney DR: Intramural hematoma of the duodenum. Arch Surg 1988, 123:54-8.
  • [14]Sadio A, Peixoto P, Cancela E, Castanheira A, Marques V, Ministro P, Silva A, Caldas A: Intramural hematoma: a rare complication of endoscopic injection therapy for bleeding peptic ulcers. Endoscopy 2011, 43(Suppl 2):E141-2.
  • [15]Lukman MR, Jasmi AY, Niza SS: Massive dissecting intramural duodenal haematoma following endoscopic haemostasis of a bleeding duodenal ulcer. Asian J Surg 2006, 29:98-100.
  • [16]Bakkali H, Aissa I, Massou S, Wartiti L, Abouelalaa K, Balkhi H, Drissi KN: Unusual complication of noninvasive ventilation: The œsogastric pneumatosis associated with a subcutaneous emphysema. Rev Pneumol Clin 2014, 70:236-9.
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