Endoscopic Management of Post-Traumatic Transmural Duodenal Hematoma in a Pediatric Patient: Case Report

Intramural duodenal hematoma, first described in 1838, is a rare condition associated with blunt abdominal trauma, coagulopathy, anticoagulants, pancreatic disease or aneurysm, and endoscopic procedures. It usually presents with abdominal pain, nausea, and vomiting, and is diagnosed by imaging, mainly computed tomography and ultrasonography. Management is conservative or surgical depending on severity: hematomas without perforation usually resolve within a few weeks, whereas cases with perforation require surgery. Endoscopic ultrasound helps distinguish the lesion from malignant masses, and the diagnosis is often delayed because the symptoms are insidious. We report a 14-year-old boy with a persistent post-traumatic transmural duodenal hematoma that caused duodenal obstruction and was successfully treated with serial endoscopic balloon dilation after conservative management, offering a safe alternative in selected patients.