Duodenal hematoma in infancy and childhood

Abstract Although early operation in all patients with a symptomatic duodenal hematoma has been advocated, it is our experience that some of these patients can be treated successfully with nonoperative measures if an accurate diagnosis is made and provided the patient has no significant active bleeding or an associated injury requiring abdominal exploration. Duodenal obstruction due to hematoma can spontaneously resolve while the patient is under non-operative supportive management. The proper course of action should be individualized in these cases. Criteria for nonoperative treatment are: clinical, laboratory, and radiographic evidence that there are no associated injuries; no excessive or continuous blood loss; and subsidence of obstruction within 7 to 10 days.