Korean Journal of Gastrointestinal Endoscopy 2007;34(6): 346-350.
내시경적 지혈 후 발생된 폐쇄성 황달과 췌장염을 동반한 십이지장 벽내 혈종 1예
이형철·김국현*·박윤선·문희정·김태년·장병익
영남대학교 의과대학 내과학교실, *포천중문의과대학교 구미차병원 내과학교실
A Case of Intramural Duodenal Hematoma Complicated with Obstructive Jaundice and Pancreatitis following Endoscopic Hemostasis
Hyung Chul Lee, M.D., Kook Hyun Kim, M.D.*, Youn Sun Park, M.D., Hee Jung Moon, M.D., Tae Nyeun Kim, M.D. and Byung Ik Jang, M.D.
Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, *Department of Internal Medicine, College of Medicine, Pochon CHA University, Gumi, Korea
Abstract
An intramural duodenal hematoma is rarely observed in adults and may occur as an iatrogenic complication after endoscopic treatment for duodenal ulcer bleeding, particularly in patients with bleeding disorders or undergoing anticoagulant therapy. Upper gastrointestinal endoscopy, abdominal CT scan and hypotonic duodenography are used to establish a diagnosis. We report a case of an intramural duodenal hematoma complicated with obstructive jaundice and pancreatitis after endoscopic hemostasis in a patient with a cerebral infarction. A 64-year-old male had duodenal ulcer bleeding, which was treated by a local injection of epinephrine followed by hemoclipping. One to three days after the endoscopic treatment, he complained of abdominal pain and jaundice. The abdominal CT scan revealed acute, edematous pancreatitis and a huge hematoma in the 2nd to 4th portion of the duodenum. The follow-up endoscopy revealed severe stenosis of the duodenal lumen caused by an intramural hematoma. He was treated with conservative management for 18 days. There was gradual improvement in the hematoma that had been complicated by jaundice and pancreatitis.
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