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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Main Authors: Jen-Hung Chien, Tsyr-Yuh Ho, Lin Shih-Peng, Chi-Ling Lee, Shan-Fu Ou
Format: Article
Language:English
Published: Elsevier 2008-10-01
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.
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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