Sonographic diagnosis of intramural duodenal hematoma

A previously healthy 2-year-8-month-old boy was brought to the emergency department due to non-bilious vomiting several times in one day. Refractory vomiting persisted after fasting with intramuscular metoclopramide use. On evaluation, the patient appeared mildly anxious and showed no signs of acute abdomen. The vital signs were as follows: temperature 36.9 °C, blood pressure 122/64 mmHg, pulse 86 beats/min, respiratory rate 20 breaths/min, and oxygen saturation 100% breathing ambient air. Abdominal sonography revealed a heterogeneous mass lesion along the duodenal convexity with a size of 44.2∗12.3∗13.6 mm (Fig. 1), accompanied with several hypoechoic heterogeneous lesions at the right subphrenic area.