Pediatric Duodenal Hematoma

  • Etiology: severe anterior-posterior compression trauma against spinal column due to seat belt injury, deceleration trauma, handlebar compression trauma, sports injuries, falls, blows to upper abdomen
  • Imaging: intramural hematoma causes luminal narrowing
  • Clinical: if missed initially presents with vomiting with feeding

Radiology Cases of Duodenal Hematoma

CT of duodenal hematoma
Contiguous slices from an axial CT with IV and oral contrast of the abdomen shows medial to the ascending colon the contrast-filled lumen of the duodenum narrowing to a point as it nears the midline (above) and then being narrowed as it crosses anterior to the spine (below).
Upper GI of duodenal hematoma in child abuse
AP image from an upper GI exam shows diffuse persistent narrowing of the lumen of the second and third portions of the duodenum.