CASE 233: ABDOMINAL MASS AFTER TRAUMA, Dr PHAN THANH HẢI - Dr PHÙ VĂN TUỐT, BÌNH AN HOSPITAL, VIETNAM

MAN 23 YO, for ONE WEEK UNDERWENT A BLUNT TRAUMA NEAR PARAUMBILIC AREA BY BICYCLE ACCIDENT, HE WAS GETTING WORSE MORE AND MORE  BY VOMITTING, AND CANNOT EATING. 

CLINICAL EXAMINATION OF ABDOMEN REVEALED A MASS OVER RIGHT KIDNEY, POSITIVE REBOUND TENDENESS ( PHOTO).

ULTRASOUND in FIRST LINE SHOWED THE STOMACH WAS DILATED. THE  MASS WAS AT DUODENUM D2-D3, SIZE OF 5 CM, CYSTIC STRUCTURE BUT NO FREE FLUID IN HIS ABDOMEN ( 3 U/S IMAGES).

XRAYS of ABDOMEN in STANDING POSITION and BARIUM MEAL  SHOWED THAT DOUDENUM  in OBSTRUCTION.

 

MSCT of abdomen: this mass was from duodenum wall,  cystic structure,  size of 5 cm. Radiologist made diagnosis  of hematoma intraduodenum wall without bleeding into abdomen.

Medical treatment by nasogatric suction  and  wait and see the progress.

 

AFTER 4 DAYS for  NASOGASTRIC SUCTION and IV FLUID REPLACEMENT, NASO GASTRIC TUBE HAD BEEN REMOVED and XRAY BARIUM MEAL for  BEING SURE NO OBSTRUCTION of  DUODENUM. HE CAN DRINK and  EAT  and  RECOVERY STAGE DURING SO FAST (see XRay barium meal on  Jan 24, 2014).

IT IS FIRST STEP of  SUCCESS of MEDICAL TREATMENT for HEMATOMA DUODENAL WALL POST TRAUMA.

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