Hematoma duodenal intramural post biopsia endoscópica: una complicación inusual. Reporte de un caso pediátrico

The intramural duodenal hematoma is a rare but well-known collateral complication after an endoscopic biopsy. It is more frequent after abdominal trauma or therapeutic endoscopy and even more in anticoagulant-treated patients or those with coagulation disorders. Clinical presentation consists of the symptoms and the signs of the intestinal obstruction, the pancreatitis and the conjugated hyperbilirubinemia. We report a pediatric case of a five-year-old female patient who was being checked for celiac disease. Without known previous bleeding or coagulation disorders, she presented a intramural duodenal hematoma with pancreatitis as a complication of the endoscopic biopsy procedure. A summary of the symptomatology and the signs, the diagnosis, the conservative treatment and evolution is described and also a reminder to paediatric endoscopists to be aware that this unusual complication can occur. This case presents the possibility that an intramural duodenal hematoma can be a complication of a duodenal endoscopic biopsy in patients with no coagulations disorders. This hematoma subsided with a non-surgical treatment (conservative), assisted by the joint work of a pediatric gastroenterologist and surgeon.