Spontaneous intramural duodenal hematoma in type 2B von Willebrand disease

Derrick D. Eichele, Meredith Ross, Patrick Tang, Grant F. Hutchins, Mark E Mailliard

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Intramural duodenal hematoma is a rare cause of a proximal gastrointestinal tract obstruction. Presentation of intramural duodenal hematoma most often occurs following blunt abdominal trauma in children, but spontaneous non-traumatic cases have been linked to anticoagulant therapy, pancreatitis, malignancy, vasculitis and endoscopy. We report an unusual case of spontaneous intramural duodenal hematoma presenting as an intestinal obstruction associated with acute pancreatitis in a patient with established von Willebrand disease, type 2B. The patient presented with abrupt onset of abdominal pain, nausea, and vomiting. Computed tomography imaging identified an intramural duodenal mass consistent with blood measuring 4.7 cm × 8.7 cm in the second portion of the duodenum abutting on the head of the pancreas. Serum lipase was 3828 units/L. Patient was managed conservatively with bowel rest, continuous nasogastric decompression, total parenteral nutrition, recombinant factor VIII (humateP) and transfusion. Symptoms resolved over the course of the hospitalization. This case highlights an important complication of an inherited coagulopathy.

Original languageEnglish (US)
Pages (from-to)7205-7208
Number of pages4
JournalWorld Journal of Gastroenterology
Volume19
Issue number41
DOIs
StatePublished - Nov 7 2013

Fingerprint

Type 2 von Willebrand Disease
Hematoma
Pancreatitis
Total Parenteral Nutrition
Intestinal Obstruction
Factor VIII
Vasculitis
Decompression
Lipase
Duodenum
Anticoagulants
Nausea
Abdominal Pain
Endoscopy
Vomiting
Gastrointestinal Tract
Pancreas
Hospitalization
Tomography
Wounds and Injuries

Keywords

  • Duodenal hematoma
  • Von Willebrand disease

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Spontaneous intramural duodenal hematoma in type 2B von Willebrand disease. / Eichele, Derrick D.; Ross, Meredith; Tang, Patrick; Hutchins, Grant F.; Mailliard, Mark E.

In: World Journal of Gastroenterology, Vol. 19, No. 41, 07.11.2013, p. 7205-7208.

Research output: Contribution to journalArticle

Eichele, Derrick D. ; Ross, Meredith ; Tang, Patrick ; Hutchins, Grant F. ; Mailliard, Mark E. / Spontaneous intramural duodenal hematoma in type 2B von Willebrand disease. In: World Journal of Gastroenterology. 2013 ; Vol. 19, No. 41. pp. 7205-7208.
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