A 25-year-old man, Ramesh presented to emergency with severe colicky abdominal pain & vomiting after a blunt abdominal trauma due to assault. CECT reveals an obstruction of the duodenum with a coiled spring appearance of the 2nd and 3rd pa of duodenum. Which of the following is the next best step in management of this patient?
Correct Answer: Nasogastric suction and observation
Description: The clinical scenario and investigations point toward a diagnosis of Duodenal hematoma resulting from blunt abdominal trauma It should be managed initially with observation since the majority of duodenal hematomas resolve spontaneously. However, in patients having other abdominal organ injuries it should be managed by immediate laparotomy, duodenal exploration with drainage of the hematoma If obstructive symptoms do not resolve after 2 weeks, patient should undergo exploration and evacuation of the hematoma in order to rule out a perforation or injury to the head of the pancreas.
Category:
Surgery
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