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Korean J Gastroenterol  <  Volume 73(1); 2019 <  Articles

Korean J Gastroenterol 2019; 73(1): 39-44  https://doi.org/10.4166/kjg.2019.73.1.39
Huge Intramural Duodenal Hematoma Complicated with Obstructive Jaundice following Endoscopic Hemostasis
Hak Su Kim1, Hee Kyoung Kim2, Won Hee Kim3 , Sung Pyo Hong3 and Joo Young Cho3
Department of Gastroenterology and Hepatology, Incheon Sarang Hospital1, Incheon; Department of Gastroenterology and Hepatology, Cheonggu Sungsim Hospital2, Seoul; Digestive Disease Center, CHA Bundang Medical Center, CHA University3, Seongnam, Korea
Correspondence to: Won Hee Kim, Digestive Disease Center, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 13496, Korea. Tel: +82-31-780-5212, Fax: +82-31-780-5219, E-mail: ari98@cha.ac.kr, ORCID: https://orcid.org/0000-0003-0013-0211
Received: June 1, 2018; Revised: June 21, 2018; Accepted: June 29, 2018; Published online: January 25, 2019.
© The Korean Journal of Gastroenterology. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Intramural hematoma of the duodenum is a relatively unusual complication associated with the endoscopic treatment of bleeding peptic ulcers. Intramural hematomas are typically resolved spontaneously with conservative treatment alone. We report a case of an intramural duodenal hematoma following endoscopic hemostasis with epinephrine injection therapy, which was associated with transient obstructive jaundice in a patient undergoing hemodialysis. The patient developed biliary sepsis due to obstruction of the common bile duct secondary to the huge hematoma. He was treated with fluoroscopy-guided drainage catheter insertion, which spontaneously resolved the biliary sepsis through conservative treatment in 6 weeks. Fluoroscopy-guided drainage may impact the treatment of intramural hematomas that involve life-threatening complications.
Keywords: Duodenal ulcer; Hematoma; Cholestasis; Drainage


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