Man 23 yo, after 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. Ultrasound first 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.
Xray of abdomen in standing and barium meal showed that duodenum 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 . It is first step of success of medical treatment for hematoma duodenal wall post trauma.