INTESTINAL OCCLUSION DUE TO DUODENAL HEMATOMA AFTER SPORTS ACCIDENT: CASE REPORT.
case report
Abstract
Introduction. Duodenal injuries are uncommon in the adult patient (4,3%) and most of the time they are caused by penetrating trauma, although they can also be due to blunt trauma, especially traffic accidents. The clinical presentation as upper intestinal obstruction secondary to duodenal hematoma is infrequent and has not been described in sport accidents. The second part of the duodenum is the most frequently affected area, which is usually accompanied by injury to neighboring structures The diagnosis is usually late since the symptoms are nonspecific and the laboratory studies are unrevealing. Treatment will depend on the mechanism of injury, the grade of injury and the patient's hemodynamic status. Low-grade injuries can be managed conservatively, and more complex cases may require surgical management, such as duodenal resection and reconstruction procedures. The aim of this report is to present the clinical case of an adult patient with occlusive symptoms secondary to a duodenal haematoma due to a sports accident. Given its infrequency, we carry out a bibliographic review and discuss the most controversial aspects.
Case summary. A 16 year old male who came to the emergency room with abdominal pain and vomiting after getting a middle abdominal trauma. This occurred while he was practicing football, receiving an impact with the knee of another player during a game. He was hemodynamically stable and on physical examination he showed pain in the epigastrium and a sensation of occupation in that area. A computed tomography (CT) scan showed a large duodenal haematoma that, due to its size, conditioned occlusive symptoms. The patient was admitted to the hospital and received conservative treatment with gastric decompression, parenteral nutrition, and analytical and imaging controls. He evolved favorably and was discharged without further complications.
Conclusions. Duodenal hematomas secondary to sports trauma are uncommon injuries in adults. Conservative management of low-grade injuries is effective, safe, and avoids more aggressive attitudes and their possible complications.
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