A Lethal Complication of Endoscopic Therapy: Duodenal Intramural Hematoma

<div>Coronal T2A magnetic resonance imaging. The image shows a hematoma with a diameter of approximately <svg height="8.69876pt" id="M1" style="vertical-align:-0.3629799pt" version="1.1" viewbox="-0.0498162 -8.33578 51.9118 8.69876" width="51.9118pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M389 0V32C297 38 291 46 291 118V635C234 613 175 595 109 583V556L161 554C203 552 207 547 207 497V118C207 46 201 38 110 32V0H389Z" id="g50-50"></path><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"></glyph.data></g><g transform="matrix(.013,0,0,-0.013,6.331,0)"><path d="M245 635C92 635 37 457 37 312C37 149 91 -12 244 -12C395 -12 449 166 449 312C449 469 395 635 245 635ZM243 598C332 598 358 454 358 312C358 173 334 26 245 26C158 26 128 174 128 313S152 598 243 598Z" id="g50-49"></path><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"></glyph.data></g><g transform="matrix(.013,0,0,-0.013,12.662,0)"><path d="M117 -12C153 -12 178 12 178 50C178 84 153 110 118 110C84 110 59 84 59 50C59 12 84 -12 117 -12Z" id="g50-47"></path><glyph.data ascent="3443" descent="-2856" horiz-adv-x="237" vert-adv-y="237"></glyph.data></g><g transform="matrix(.013,0,0,-0.013,15.743,0)"><path d="M389 0V32C297 38 291 46 291 118V635C234 613 175 595 109 583V556L161 554C203 552 207 547 207 497V118C207 46 201 38 110 32V0H389Z" id="g50-50"></path><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"></glyph.data></g><g transform="matrix(.013,0,0,-0.013,25.014,0)"><path d="M547 55L345 261L547 468L508 508L306 301L104 508L65 468L267 261L65 55L104 14L306 221L508 14L547 55Z" id="g54-42"></path><glyph.data ascent="3443" descent="-2856" horiz-adv-x="611" vert-adv-y="611"></glyph.data></g><g transform="matrix(.013,0,0,-0.013,35.898,0)"><path d="M158 548H390L417 615L410 623H122L83 318C105 326 143 337 185 337C296 337 350 275 350 188C350 116 308 42 225 42C164 42 122 74 100 93C90 101 82 99 72 92C60 82 51 68 50 59C48 46 52 38 66 24C82 9 125 -12 172 -12C225 -11 292 15 346 59C408 108 437 166 437 226C437 309 371 397 242 397C214 397 170 382 133 369L158 548Z" id="g50-54"></path><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"></glyph.data></g><g transform="matrix(.013,0,0,-0.013,42.229,0)"><path d="M117 -12C153 -12 178 12 178 50C178 84 153 110 118 110C84 110 59 84 59 50C59 12 84 -12 117 -12Z" id="g50-47"></path><glyph.data ascent="3443" descent="-2856" horiz-adv-x="237" vert-adv-y="237"></glyph.data></g><g transform="matrix(.013,0,0,-0.013,45.31,0)"><path d="M141 347C171 480 264 541 327 570C364 587 403 599 436 605L429 641C389 634 339 622 300 609C191 570 37 458 37 239C37 86 126 -12 245 -12C367 -12 454 89 454 210C454 314 380 397 272 397C252 397 230 390 208 380L141 347ZM231 338C323 338 366 257 366 174C366 108 340 27 263 27C180 27 129 123 129 244C129 268 130 292 135 310C158 323 193 338 231 338Z" id="g50-55"></path><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"></glyph.data></g></svg> cm. Bile ducts are dilated (common bile duct (CBD) diameter 13.4 mm). Distally, pressure caused by the hematoma on the CBD and reduced CBD diameter is apparent (blue arrow).</div>

Case Reports in Gastrointestinal Medicine

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Figure 5

Figure 5: A Lethal Complication of Endoscopic Therapy: Duodenal Intramural Hematoma 