Jejunal Bowel Loop Hematoma: An Ultrasound diagnosis
A 6 yrs old female child with h/o blunt abdominal trauma 3 days back, episode of malena, & having pain abdomen, was referred for ultrasound evaluation of abdomen . At USG a well defined hypoechoic oval mass was seen along jejunal bowel loop, likely involving its wall, with slight exophytic bulge , & focally distorting gut signature [ fig 1 & 2] . The mass did not reveal internal vascularity on Doppler. The affected segment of jejunum was sluggishly motile , & showed mild luminal narrowing with proximal fullness. Surprisingly no any other evidence of intraabdominal free fluid , mesenteric mass or fluid ,or solid visceral injury was detected on ultrasound . In light of h/o abdominal injury , a diagnosis of jejunal loop hematoma was suggested , which was confirmed at surgery ; isolated jejunal hematoma [ see fig- 3]. Case submitted by Dr. Subhash Tailor, MD, Bhilwara [ Rajasthan , India]
Fig 1 - Left paraumbilical transverse USG image shows a well defined hypoechoic mass along jejunal bowel loop making exophytic bulge .
Fig 2 - Obliquely longitudinal USG scan shows the same mass along jejunal loop compressing the lumina. The mass was vascular on color Doppler.
Fig 3 – Per operative photograph revealing isolated segmental jejunal wall hematoma.
[ Operative photograph courtesy ; Dr. Gaurav Bahety M.Ch., Bhilwara ]
Jejunal Bowel Loop Hematoma: An Ultrasound diagnosis Reviewed by Sumer Sethi on Friday, September 06, 2013 Rating: