[Conservative treatment of post-traumatic periduodenal hematoma: presentation of a clinical case and review of the literature]. / Trattamento conservativo di ematoma periduodenale post-traumatico: presentazione di un caso clinico e revisione della letteratura.

The authors describe a case of post-traumatic hematoma of the duodenum in a two years old child. This is a very rare condition in paediatric age, but with the increasing incidence of traumatic pathology it can be predicted an increase of this condition. The duodenal hematoma can be treated either with surgical approach or with conservative treatment. The authors discuss the characteristics of the pathology, the etiopathogenetic mechanism, and propose the same classification adopted by some french authors. The type of lesion indicates the adequate therapy; in particular in the case report (type 1) a conservative treatment is adopted. The laboratory parametres are significative but none is diagnostic. In the present case the amylasemia is not elevated until two weeks after the trauma. Very important for diagnosis are T.C., roentgenography and echotomography, the last one can be easily used for the control of the resolution of the hematoma. The conservative treatment is based on nasogastric suction and parenteral nutrition; although the role of nonoperative treatment is emphasized, the importance of careful assessment for signs of peritonitis or enlarging tender mass cannot be overlooked.