Duodenal Hematoma: Treatment strategy and review of ten cases

Introduction:Pediatric duodenal hematomas due to blunt abdominal trauma are uncommon. The natural history of this trauma has not been well-characterized. Treatment strategies range from non-operative management to surgical decompression. The purpose of this study is to review our experience with this injury.Method:We reviewed our experiences with this injury as a retrospective study, using the data collection and hospital courses of referral trauma patients to our center from January 2010-July 2017. Result: Mechanisms of the injury included motor vehicle blunt abdominal trauma (n = 6), trauma due to falling (n = 3), and suffering a blow to the abdomen (n = 1). Eight patients had grade I hematomas and two had grade II. Hematomas were mostly seen in the second portion of the duodenum. Six patients underwent a laparotomy for concerns of hollow viscus injury and four of them underwent operativedrainage. Twelve patients received parenteral nutrition (PN) for a median duration of 9 days. Discussion:Duodenal hematomas as a consequence of blunt abdominal trauma in children can be successfully treated non-operatively with acceptable morbidity, although traumatic duodenal hematoma as an intra operative finding can be decompressed successfully.