ABSTRACT CONTEXT Spontaneous intramural duodenal
hematoma is uncommon and is usually associated with coagulopathy,
anticoagulant therapy and endoscopic
procedures. The aim here was to describe a case of intramural duodenal
hematoma caused by chronic exacerbation of
pancreatitis. CASE
REPORT A 46-year-old
male with chronic
alcoholic pancreatitis was admitted to
hospital due to
abdominal pain,
melena and low
hemoglobin. An intramural duodenal
hematoma with active
bleeding was detected and selective angioembolization was warranted. The
patient evolved with a perforated
duodenum and underwent
laparotomy with exclusion of the
pylorus and Roux-en-Y
gastrojejunostomy. He was discharged nine days later.
CONCLUSION:
Intramural duodenal
hematoma is a rare complication of
pancreatitis. Selective embolization is the preferred
treatment for hemorrhagic
complications of
pancreatitis. However, the
risk of visceral
ischemia and perforation should be considered.