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

BMC Gastroenterology

Case Report

Wei-Cheng Huang¹  Fat-Moon Suk²  Chih-Hsin Lee³ 

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

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

DOI  :  10.1186/s12876-015-0351-x

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

来源: Springer

【 摘 要 】

BackgroundEsophagogastroduodenal 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 presentationA 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.ConclusionBased 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】

CC BY   
© Huang et al. 2015