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JOP. 2012 Nov 10;13(6):690-2. doi: 10.6092/1590-8577/1039.

Traumatic focal pancreatitis with retro-duodenal hematoma: a rare cause of combined biliary and gastric outlet obstruction.

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  • 1Department of Hepato-biliary-pancreatic Surgery and Liver Transplantation, University Hospital Birmingham NHS Trust. Birmingham, UK.

Abstract

CONTEXT:

Focal post-traumatic acute pancreatitis causing combined duodenal and biliary obstruction is extremely rare.

CASE REPORT:

A 16-year-old boy presented with acute upper abdominal pain which was clinically and biochemically consistent with mild acute pancreatitis. There was no etiological factor identified initially, although a history of blunt abdominal trauma was later discovered. He soon developed features of gastric outlet obstruction and obstructive jaundice over 48 hours. A CT scan showed a retroduodenal mass causing compression of both the duodenum and bile duct. At exploration, this was found to be a walled off hematoma. There was evidence of focal pancreatitis in the head of pancreas. Evacuation of the hematoma cured the gastric outlet and biliary obstruction.

CONCLUSION:

The triad of pancreatitis, gastric outlet and biliary obstruction along with a mass lesion on cross sectional imaging in young adults should raise the suspicion of a hematoma as a probable cause.

PMID:
23183403
[PubMed - indexed for MEDLINE]
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