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Intramural duodenal haematoma caused by pancreatic fistula due to exacerbation of chronic pancreatitis
  1. Junya Kitadani,
  2. Naohisa Yamade,
  3. Hiroaki Nakai,
  4. Koichi Shima
  1. Department of Surgery, Shingu Municipal Medical Center, Shingu, Japan
  1. Correspondence to Dr Junya Kitadani, kitadani{at}

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Intramural duodenal haematoma (IDH) is a rare condition forming haematoma within the wall of the duodenum, which was first reported in 1838 by MacLauchlan.1 IDH derived from acute or chronic pancreatitis is rarely described, the mechanism remaining unknown. A 65-year-old man with history of heavy drinking and chronic hepatitis was admitted to our hospital with sudden vomiting and right-lateral abdominal pain. Abdominal pain and vomiting continued after admission, so a nasogastric tube was inserted. Contrast-enhanced CT scans of the abdomen found a 60×80 mm heterogeneous mass with intraluminal leakage of contrast agent-like bleeding along the second portion of the duodenum, diffuse expansion of the pancreatic duct with pancreatic stone and ascites on the surface of the liver (figure 1). We first considered whether …

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