Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 28, 2022; 28(20): 2243-2247
Published online May 28, 2022. doi: 10.3748/wjg.v28.i20.2243
Endoscopic management of intramural spontaneous duodenal hematoma: A case report
Giorgio Valerii, Vittorio Maria Ormando, Carlo Cellini, Luca Sacco, Carmelo Barbera
Giorgio Valerii, Carlo Cellini, Carmelo Barbera, Gastroenterology and Endoscopy Unit, Ospedale G. Mazzini, Teramo 64100, Italy
Vittorio Maria Ormando, Gastroenterology and Endoscopy Unit, AORN San Giuseppe Moscati, Avellino 83100, Italy
Luca Sacco, Surgery Unit, Ospedale G. Mazzini, Teramo 64100, Italy
Author contributions: All authors contributed to writing this case report.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare no conflict of interest for this case report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Giorgio Valerii, MD, PhD, Doctor, Gastroenterology and Endoscopy Unit, Ospedale G. Mazzini, Piazza Italia, 1, Teramo 64100, Italy.
Received: November 28, 2021
Peer-review started: November 28, 2021
First decision: January 8, 2022
Revised: January 12, 2022
Accepted: April 21, 2022
Article in press: April 21, 2022
Published online: May 28, 2022
Processing time: 179 Days and 18.3 Hours

Intramural duodenal hematoma is a rare condition described for the first time in 1838. This condition is usually associated with blunt abdominal trauma in children. Other non-traumatic risk factors for spontaneous duodenal haematoma include several pancreatic diseases, coagulation disorders, malignancy, collagenosis, peptic ulcers, vasculitis and upper endoscopy procedures. In adults the most common risk factor reported is anticoagulation therapy. The clinical presentation may vary from mild abdominal pain to acute abdomen and intestinal obstruction or gastrointestinal bleeding.


The aim of this case summary is to show a case of intramural spontaneous hematoma with symptoms of intestinal obstruction that was properly drained endoscopically by an innovative system lumen-apposing metal stent Hot AXIOS™ stent (Boston Scientific Corp., Marlborough, MA, United States).


Endoscopic lumen-apposing metal stent Hot AXIOS™ stent is a safe and feasible treatment of duodenal intramural hematoma in our case.

Keywords: Duodenal hematoma, Several pancreatic diseases, Endoscopy complication, AXIOS™ stent, Case report

Core Tip: The present case explored the feasibility, safety and efficacy of endoscopic ultrasound-guided drainage of spontaneous duodenal hematoma. The new lumen-apposing self-expandable metallic stent Hot AXIOS™ could be considered a valid alternative to conventional endoscopic incision of the hematoma by using a needle-knife, a biopsy forceps or surgical drainage and percutaneous drainage to relieve pain and a persistent duodenal ulcer.