BLUNT TRAUMA to the upper abdomen may result in traumatic intramural duodenal hematoma producing the findings of high small intestinal obstruction. Luminal occlusion of the duodenum by an enlarging hematoma in the gut wall due to disruption of subserosal or submucosal vessels is the mechanism of occurrence of the pathologic process. The diagnosis is confirmed by upper gastrointestinal roentgenological studies demonstrating an intramural duodenal mass with a coil-spring mucosal pattern overlying the mass.
Mc Lachlan1 described the first case in 1838. Shaw and Cinque2 in 1964 reported a case in a 9-year-old child and found in the literature only 22 other instances in children under 16 years of age. The literature further reveals, and our experience substantiates, that history of trauma may be elicited, but that frequently this history is obtained only after the diagnosis is established by radiographic studies or operation. Instances of spontaneous intra mural hemorrhage