Duodenum
Duodenal hematoma
may occur following direct blunt abdominal trauma and are more commonly seen in children.
Blood collects between the submucosal and muscular layers of the duodenum causing obstruction.
Most resolve in 1-2 weeks.
Tx
best initial = NGT suction and parenteral nutrition
Surgical evacuation if conservative Mx failed
Infantile Hypertrophic Pyloric Stenosis
Pyloric stenosis is most common in first-born boys and typically begins at age 3-5 weeks with projectile, nonbilious vomiting after every feed.
Palpable olive-shaped mass in RUQ may be occurred.
Lab:
Hypochloremic, hypokalemic metabolic alkalosis
Dx:
Ultrasound shows elongated, thickened pylorus
Tx
Normalization of electrolytes and correction of alkalosis prior to surgery (pyloromyotomy) can reduce the risk of postoperative apnea and improve overall outcomes.