Korean J Gastrointest Endosc > Volume 39(4); 2009 > Article
Korean Journal of Gastrointestinal Endoscopy 2009;39(4): 240-243.
항응고제 복용 중인 고령의 환자에서 십이지장 궤양출혈의 내시경적 치료 후 발생한 십이지장 근육 내 혈종 1예
인제대학교 의과대학 일산백병원 내과학교실
Intramural Duodenal Hematoma following Endoscopic Epinephrine and Thrombin Injection for Bleeding Duodenal Ulcer in a Geriatric Patient with a History of Anticoagulant Drug Use
Jung Bok Park, M.D., Won Ki Bae, M.D., Hyoung Don Lee, M.D., Jung Hoon Kim, M.D., Nam-Hoon Kim, M.D., Kyung-Ah Kim, M.D., June Sung Lee, M.D. and Young Soo Moon, M.D.
Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
Intramural duodenal hematoma is a rare injury of the duodenum due mainly to blunt abdominal trauma and, less commonly, a hematologic disorder, anticoagulant drug use and post-therapeutic endoscopy. Intramural duodenal hematoma following endoscopic intervention is even rarer. Patients usually present with gradual onset of vomiting and abdominal pain approximately 48 h post-injury. The hematoma usually resolves in 1∼2 weeks with conservative therapy. Surgery is usually reserved for patients with suspected duodenal perforation, bile or pancreatic duct compression and inadequate resolution of the hematoma after 1∼2 weeks of conservative therapy. We describe a patient with a history of anticoagulant drug use who developed intramural duodenal hematoma after endoscopic hemostasis of a bleeding duodenal ulcer. Conservative therapy produced a successful outcome. (Korean J Gastrointest Endosc 2009;39:240-243)
Key Words: Intramural hematoma, Duodenum, Endoscopic hemostasis
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