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April 1959

Intramural Hematoma of the Duodenum: Report of a Case with an Unusual Complication

Author Affiliations

Galveston, Texas
Assistant Professor of Surgery (Dr. E. B. Rowe); Instructor, Department of Internal Medicine (Dr. Baxter); Associate Professor of Radiology (Dr. C. W. Rowe), University of Texas Medical Branch.

AMA Arch Surg. 1959;78(4):560-564. doi:10.1001/archsurg.1959.04320040056016

Acute obstruction of the duodenum in the second and third parts is infrequent. The commonest causes of such an obstruction are congenital defects of the duodenum and pancreas, anomalies of rotation of the bowel, mesenteric artery syndrome, ulcers, neoplasms of the ampulla of Vater and duodenum, gallstones and foreign bodies, and invasive tumors of surrounding organs. Duodenal obstruction due to intramural hematoma was practically unknown until rather recently.

The first report of a case of duodenal obstruction due to intramural hematoma was made by McLauchlan in 1838.8 In 1948 Liverud described the x-ray findings of intramural hematoma, and, although in his case the hematoma was in the first part of the jejunum, the x-ray appearance was almost identical with that of intramural hematoma of the duodenum.6

Felson and Levin, in 1954, reported four cases of intramural duodenal hematoma and described in detail the x-ray appearance produced by barium

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