Abstract
Duodenal intramural hematoma (DIH) usually occurs in childhood and young adults following blunt abdominal trauma. It may also develop in the presence of coagulation disorders and may rarely be an iatrogenic outcome of endoscopic procedures. Management of DIH is usually a conservative approach. A case of intramural duodenal hematoma that developed following endoscopic epinephrine sclerotherapy and/or argon plasma coagulation and that was nonresponsive to conservative therapy in a patient with chronic renal failure who died from sepsis is being discussed in this report. Clinicians should be aware of such possible complications after endoscopic hemostasis in patients with coagulation disorders.
Highlights
Endoscopic hemostatic procedures such as local injection of epinephrine, polidocanol, and fibrin tissue adhesive onto the mucosa, argon plasma coagulation (APC), and hemoclipping are commonly used for the treatment of bleeding ulcers, instead of the open surgical approaches used in the past [1]
We discuss a case of duodenal intramural hematoma (DIH), complicated by acute pancreatitis, obstructive jaundice, and sepsis, which developed after endoscopic epinephrine sclerotherapy and/or APC and which was nonresponsive to conservative therapy in a patient with chronic renal failure secondary to hypertensive nephrosclerosis
Duodenal intramural hematoma is an unusual condition in adults [3]
Summary
Endoscopic hemostatic procedures such as local injection of epinephrine, polidocanol, and fibrin tissue adhesive onto the mucosa, argon plasma coagulation (APC), and hemoclipping are commonly used for the treatment of bleeding ulcers, instead of the open surgical approaches used in the past [1]. The risks are usually considered to be minimal, there are reports describing that duodenal intramural hematomas may develop as a complication after diagnostic or therapeutic endoscopy, especially in patients susceptible to hemorrhage, such as those with chronic renal disease [2]. We discuss a case of duodenal intramural hematoma (DIH), complicated by acute pancreatitis, obstructive jaundice, and sepsis, which developed after endoscopic epinephrine sclerotherapy and/or APC and which was nonresponsive to conservative therapy in a patient with chronic renal failure secondary to hypertensive nephrosclerosis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
