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Spontaneous duodenal intramural haematoma imitating pancreatic pseudocyst
V. Prochazka, F. Marek, V. Valek, M. Hermanova, Z. Kala,
Jazyk angličtina Země Belgie
Typ dokumentu kazuistiky, časopisecké články
Odkazy
PubMed
21954742
DOI
10.1080/00015458.2011.11680746
Knihovny.cz E-zdroje
- MeSH
- diferenciální diagnóza MeSH
- hematom diagnóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci duodena diagnóza MeSH
- pankreatická pseudocysta diagnóza radiografie chirurgie MeSH
- počítačová rentgenová tomografie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Spontaneous intramural duodenal haematoma develops mostly as a complication of anticoagulation therapy. Other causes were reported only as case reports. CT diagnostics has some typical features in an intramural haematoma of the small bowel. This is especially hyperdensity of the bowel wall during the first 10 days from the onset of symptoms (30-80 HU), which could contribute to the differentiation from other infiltrative processes. These features are fully expressed only in a certain part of patients. We reported a 54 year-old female treated for epigastric pain. The patient's history, laboratory data, ultrasonography and CT findings resulted in a mistaken diagnosis of acute pancreatitis, necrosis of the pancreatic body with a subsequent development of pancreatic pseudocyst. The CT guided drainage was performed. The correct diagnosis was made one year later--surgical treatment was indicated for clinical signs of GI obstruction and CT findings of pseudocyst recurrence. During the operation, there was a finding of intramural haematoma in the duodenojejunal border. We performed an evacuation of the haematoma and gastroenteroanastomosis.
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- $a Spontaneous intramural duodenal haematoma develops mostly as a complication of anticoagulation therapy. Other causes were reported only as case reports. CT diagnostics has some typical features in an intramural haematoma of the small bowel. This is especially hyperdensity of the bowel wall during the first 10 days from the onset of symptoms (30-80 HU), which could contribute to the differentiation from other infiltrative processes. These features are fully expressed only in a certain part of patients. We reported a 54 year-old female treated for epigastric pain. The patient's history, laboratory data, ultrasonography and CT findings resulted in a mistaken diagnosis of acute pancreatitis, necrosis of the pancreatic body with a subsequent development of pancreatic pseudocyst. The CT guided drainage was performed. The correct diagnosis was made one year later--surgical treatment was indicated for clinical signs of GI obstruction and CT findings of pseudocyst recurrence. During the operation, there was a finding of intramural haematoma in the duodenojejunal border. We performed an evacuation of the haematoma and gastroenteroanastomosis.
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