{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:27:30Z","timestamp":1782865650607,"version":"3.54.5"},"reference-count":16,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background: Idiopathic duodenal hematoma is a rare clinical condition, typically associated with trauma, anticoagulation therapy, gastrointestinal procedures, or coagulopathies. We present a unique case of spontaneous duodenal hematoma in a patient without identifiable risk factors. Case presentation: We present the case of a 60-year-old Asian woman who presented to the emergency room (ER) with a 10-day history of progressive abdominal pain, early satiety, nausea, and vomiting. She had no history of trauma, anticoagulant use, or underlying predisposing conditions. On clinical evaluation, she was hemodynamically stable, and the initial laboratory results were unremarkable except for signs of dehydration and inflammation. A computed tomography (CT) scan revealed a heterogeneous lesion in the second portion of the duodenum, initially raising suspicion of a duodenal tumor. Further evaluation with magnetic resonance imaging (MRI) confirmed a duodenal hematoma with compression of the adjacent pancreas. Management and Outcome: The patient was managed conservatively with bowel rest, nasogastric decompression, intravenous (IV) fluid, and a proton pump inhibitor (PPI). Serial imaging demonstrated gradual hematoma resolution, with progressive improvement in her symptoms. She was discharged in stable condition and returned to normal activity after three weeks with complete hematoma resolution as seen on follow-up imaging. Conclusions: This case highlights the importance of considering spontaneous hematoma in the differential diagnosis of abdominal pain, even without risk factors. Early diagnosis and conservative treatment remain the mainstay of management and can lead to full recovery in uncomplicated cases.<\/jats:p>","DOI":"10.3390\/reports8020073","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T06:54:28Z","timestamp":1747724068000},"page":"73","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Idiopathic Duodenal Hematoma: A Case Report and Literature Review"],"prefix":"10.3390","volume":"8","author":[{"given":"Ebtesam","family":"Al-Najjar","sequence":"first","affiliation":[{"name":"Section of GI Oncology, Houston Methodist Neal Cancer Center, Houston Methodist Hospital, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2337-8351","authenticated-orcid":false,"given":"Abdullah","family":"Esmail","sequence":"additional","affiliation":[{"name":"Section of GI Oncology, Houston Methodist Neal Cancer Center, Houston Methodist Hospital, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7531-1178","authenticated-orcid":false,"given":"Bayan","family":"Khasawneh","sequence":"additional","affiliation":[{"name":"Section of GI Oncology, Houston Methodist Neal Cancer Center, Houston Methodist Hospital, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saifudeen","family":"Abdelrahim","sequence":"additional","affiliation":[{"name":"Challenge Early College HS, Houston, TX 77081, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maen","family":"Abdelrahim","sequence":"additional","affiliation":[{"name":"Section of GI Oncology, Houston Methodist Neal Cancer Center, Houston Methodist Hospital, Houston, TX 77030, USA"},{"name":"Faculty of Medicine, The University of Jordan, Amman 11942, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.ijscr.2015.10.028","article-title":"Surgical management of complicated intra-mural duodenal hematoma: A case-report and review of literature","volume":"17","author":"Elmoghazy","year":"2015","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2243","DOI":"10.3748\/wjg.v28.i20.2243","article-title":"Endoscopic management of intramural spontaneous duodenal hematoma: A case report","volume":"28","author":"Valerii","year":"2022","journal-title":"World J. Gastroenterol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2058460119836256","DOI":"10.1177\/2058460119836256","article-title":"Intramural duodenal hematoma: Clinical course and imaging findings","volume":"8","author":"Niehues","year":"2019","journal-title":"Acta Radiol. Open"},{"key":"ref_4","first-page":"e8491","article-title":"Spontaneous Intramural Duodenal Hematoma: A Rare Complication of Pancreatitis","volume":"12","author":"Kumar","year":"2020","journal-title":"Cureus"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1001\/archsurg.137.3.306","article-title":"Spontaneous intramural small-bowel hematoma: Clinical presentation and long-term outcome","volume":"137","author":"Abbas","year":"2002","journal-title":"Arch. Surg."},{"key":"ref_6","first-page":"146","article-title":"Acute abdomen due to complicated intramural duodenal haematoma. Case report and literature review","volume":"83","year":"2015","journal-title":"Cir. Cir."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"135","DOI":"10.5217\/ir.2018.00085","article-title":"Clinical features and outcomes in spontaneous intramural small bowel hematoma: Cohort study and literature review","volume":"17","author":"Kang","year":"2019","journal-title":"Intest. 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Imaging"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"rjad133","DOI":"10.1093\/jscr\/rjad133","article-title":"Spontaneous periduodenal hematoma: A rare surgical and radiological conundrum","volume":"2023","author":"Padar","year":"2023","journal-title":"J. Surg. Case Rep."},{"key":"ref_14","first-page":"e51330","article-title":"A Case of Idiopathic Colonic Intramural Hematoma: Successful Expectant Management","volume":"15","author":"Mayas","year":"2023","journal-title":"Cureus"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"53","DOI":"10.20408\/jti.2019.042","article-title":"Delayed manifestation of Isolated Intramural Hematoma of the duodenum resulting from Blunt abdominal Trauma","volume":"33","author":"Ha","year":"2020","journal-title":"J. Trauma Inj."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"109","DOI":"10.14701\/ahbps.2020.24.1.109","article-title":"Conservative management of traumatic acute intramural hematoma of duodenal 2nd and 3rd portion: A case report and review of literature","volume":"24","author":"Kim","year":"2020","journal-title":"Ann. Hepato-Biliary-Pancreat. 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