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Duodenal and Rectal Hematomas Complicating Endoscopic Biopsy

Use of Sonography in Pediatrics

Divisions of Pediatric Gastroenterology and Nutrition (D.D., K.J.B.) and Pediatric Radiology (H.K.R.), Mount Sinai School of Medicine, New York, New York USA.

Address correspondence to David Dunkin, MD, Division of Pediatric Gastroenterology and Nutrition, Mount Sinai School of Medicine, 1 Gustave L. Levy Pl, Box 1656, New York, NY 10029 USA., E-mail: david.dunkin{at}mssm.edu

Objective. Intramural duodenal hematomas (IDHs) after nontherapeutic endoscopic biopsy are rare. Rectal hematomas (RHs) have not been reported previously. A review of the literature revealed 18 cases of IDHs. Methods. We reviewed 3 cases that occurred within a 4-month period at our institution. Results. We report a series of 3 cases occurring within a 4-month period. In addition, we report a concurrent RH in 1 of these cases. After becoming symptomatic, 2 of these patients had a diagnosis by computed tomography, the third by sonography. All patients had conservative management and were followed with sonography. Conclusions. Sonography was found to be an accurate, safe, and nonionizing way to diagnose and follow hematomas in pediatric patients.

Key Words: duodenal hematoma • endoscopy • pediatrics • sonography

Abbreviations: CT, computed tomography • EGD, esophaogastroduodenoscopy • IDH, intramural duodenal hematoma • IVC, inferior vena cava • RH, rectal hematoma