Acquired Duodenal Obstruction in Children
Traumatic intramural hematoma of the duodenum is a rare cause of acquired duodenal obstruction in children, and a high degree of suspicion is therefore required to make an early and accurate diagnosis. We report a 6-year-old boy whose epigastrium was impacted by the handlebar of his bicycle during a...
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| Format: | Article |
| Language: | English |
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Elsevier
2008-10-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957209600085 |
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| author | Jen-Hung Chien Tsyr-Yuh Ho Lin Shih-Peng Chi-Ling Lee Shan-Fu Ou |
| author_facet | Jen-Hung Chien Tsyr-Yuh Ho Lin Shih-Peng Chi-Ling Lee Shan-Fu Ou |
| author_sort | Jen-Hung Chien |
| collection | DOAJ |
| description | Traumatic intramural hematoma of the duodenum is a rare cause of acquired duodenal obstruction in children, and a high degree of suspicion is therefore required to make an early and accurate diagnosis. We report a 6-year-old boy whose epigastrium was impacted by the handlebar of his bicycle during a traffic accident. The boy then experienced epigastralgia. Six days later, progressive bilious vomiting suggestive of gastrointestinal obstruction was noted. Imaging studies revealed a large hematoma extending from the fourth portion of the duodenum to the jejunum. Conservative methods of treatment failed to manage his condition. He underwent laparoscopic surgery to evacuate the hematoma. We also report a case of duodenal obstruction in a previously healthy 2-year-old girl who presented for the first time with acute symptoms of proximal intestinal obstruction. Contrast examinations showed apparent barium retention over the stomach and proximal duodenum. She underwent surgery due to persistent obstruction, and a mushroom-like foreign body was detected embedded in the orifice of the windsock duodenal web. After duodenoduodenostomy and removal of the bezoar, she had a smooth recovery and tolerated feeding well. We conclude that blunt abdominal trauma and incomplete duodenal obstruction, such as that caused by duodenal web, should be considered as possible causes of acquired proximal gastrointestinal obstruction in previously healthy children, despite their rarity. |
| format | Article |
| id | doaj-art-7e55f15a6db544aeb4fbd32140c70e9a |
| institution | OA Journals |
| issn | 1875-9572 |
| language | English |
| publishDate | 2008-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj-art-7e55f15a6db544aeb4fbd32140c70e9a2025-08-20T02:00:39ZengElsevierPediatrics and Neonatology1875-95722008-10-0149519319610.1016/S1875-9572(09)60008-5Acquired Duodenal Obstruction in ChildrenJen-Hung Chien0Tsyr-Yuh Ho1Lin Shih-Peng2Chi-Ling Lee3Shan-Fu Ou4Department of Pediatrics, Zuoying Armed Forces General Hospital, Kaohsiung, TaiwanDepartment of Pediatrics, Zuoying Armed Forces General Hospital, Kaohsiung, TaiwanHualien Armed Forces General Hospital, Hualien, TaiwanDepartment of Pediatrics, Zuoying Armed Forces General Hospital, Kaohsiung, TaiwanDepartment of Pediatrics, Zuoying Armed Forces General Hospital, Kaohsiung, TaiwanTraumatic intramural hematoma of the duodenum is a rare cause of acquired duodenal obstruction in children, and a high degree of suspicion is therefore required to make an early and accurate diagnosis. We report a 6-year-old boy whose epigastrium was impacted by the handlebar of his bicycle during a traffic accident. The boy then experienced epigastralgia. Six days later, progressive bilious vomiting suggestive of gastrointestinal obstruction was noted. Imaging studies revealed a large hematoma extending from the fourth portion of the duodenum to the jejunum. Conservative methods of treatment failed to manage his condition. He underwent laparoscopic surgery to evacuate the hematoma. We also report a case of duodenal obstruction in a previously healthy 2-year-old girl who presented for the first time with acute symptoms of proximal intestinal obstruction. Contrast examinations showed apparent barium retention over the stomach and proximal duodenum. She underwent surgery due to persistent obstruction, and a mushroom-like foreign body was detected embedded in the orifice of the windsock duodenal web. After duodenoduodenostomy and removal of the bezoar, she had a smooth recovery and tolerated feeding well. We conclude that blunt abdominal trauma and incomplete duodenal obstruction, such as that caused by duodenal web, should be considered as possible causes of acquired proximal gastrointestinal obstruction in previously healthy children, despite their rarity.http://www.sciencedirect.com/science/article/pii/S1875957209600085blunt abdominal traumachildrenduodenal obstructionduodenal webintramural duodenal hematoma |
| spellingShingle | Jen-Hung Chien Tsyr-Yuh Ho Lin Shih-Peng Chi-Ling Lee Shan-Fu Ou Acquired Duodenal Obstruction in Children Pediatrics and Neonatology blunt abdominal trauma children duodenal obstruction duodenal web intramural duodenal hematoma |
| title | Acquired Duodenal Obstruction in Children |
| title_full | Acquired Duodenal Obstruction in Children |
| title_fullStr | Acquired Duodenal Obstruction in Children |
| title_full_unstemmed | Acquired Duodenal Obstruction in Children |
| title_short | Acquired Duodenal Obstruction in Children |
| title_sort | acquired duodenal obstruction in children |
| topic | blunt abdominal trauma children duodenal obstruction duodenal web intramural duodenal hematoma |
| url | http://www.sciencedirect.com/science/article/pii/S1875957209600085 |
| work_keys_str_mv | AT jenhungchien acquiredduodenalobstructioninchildren AT tsyryuhho acquiredduodenalobstructioninchildren AT linshihpeng acquiredduodenalobstructioninchildren AT chilinglee acquiredduodenalobstructioninchildren AT shanfuou acquiredduodenalobstructioninchildren |