alexa Duodenal Hematoma and Pancreatitis Complicating Endosco
ISSN: 2167-1222

Journal of Trauma & Treatment
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Case Report

Duodenal Hematoma and Pancreatitis Complicating Endoscopic Intestinal Biopsy in a Boy with Noonan Syndrome

E. Leva1*, F. Macchini1, A. Di Cesare1, R. Arnoldi1, V. Gentilino1, G. Brisighelli1, G. Farris1, A. Morandi1, M. Torricelli1, Massimo Agosti2 and Eugenio Cocozza2
1Department of Pediatric Surgery, Fondazione IRCCS “Ca’ Granda” – Ospedale Maggiore Policlinico, Milano, Italy
2Azienda Ospedaliera di Circolo, Varerse, Italy
Corresponding Author : Ernesto Leva
Department of Pediatric Surgery
Fondazione IRCCS “Ca’ Granda” – Ospedale Maggiore Policlinico
Milano, Italy
E-mail: [email protected]
Received March 08, 2012; Accepted March 22, 2012; Published March 25, 2012
Citation: Leva E, Macchini F, Cesare AD, Arnoldi R, Gentilino V et al. (2012) Duodenal Hematoma and Pancreatitis Complicating Endoscopic Intestinal Biopsy in a Boy with Noonan Syndrome. J Trauma Treatment 1:122. doi:10.4172/2167-1222.1000122
Copyright: © 2012 Leva E, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Duodenal intramural hematoma is a rare condition, mostly described in children and young adults that can be a complication of duodenal biopsy, especially in patients with predisposing hemorrhagic diathesis. It can determine secondary pancreatitis because of ampullary hematoma. Noonan Syndrome (NS) is an autosomal dominant disorder characterized by short stature, typical facial dysmorphisms, congenital heart defects and other anomalies such as bleeding problems which have been reported in up to 55% of patients. We herein report a case of duodenal hematoma with pancreatitis developed after endoscopic biopsy in a boy who was initially suspected of having celiac disease on the base of his short stature and growth retardation. Afterwards a more careful past medical history collection and objective examination revealed characteristic features of NS which could have been picked-up in advance, thus avoiding an investigation, such as the duodenal endoscopic biopsy, which in NS patient is potentially more risky.

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