Objective:To explore the clinical and imaging features of intramural duodenal hematoma in children,improve the diagnostic accuracy and reduce unnecessary surgery.Methods:Eleven children with intramural duodenal hematoma with complete clinical and imaging data diagnosed surgically and/or clinically in our hospital from August 2011 to March 2021 were analyzed retrospectively.X-ray examinations were performed in 10 cases,upper gastrointestinal radiography in 3 cases and plain and enhanced CT scanning of the upper abdomen were performed in 11 cases.Results:No pneumoperitoneum was found in 10 X-ray examinations.Upper gastrointestinal angiography showed duodenal incomplete obstruction in 3 cases.CT showed cystic lesions along with the duodenum in 11 cases,ranging from 3.3～9.4 cm,with a median size of 4.6 cm.The cyst walls were thick,with a thickness of 1.9～6.9 mm and a median thickness of 3.4 mm.The density in the capsules was uneven,and the centers were higher density—ice melting sign.There were 2 cases of cyst wall mild enhancement,10 cases of ascites,4 cases of slight dilatation of intrahepatic and extrahepatic bile ducts,1 case of pancreatic injury with peripheral blur,and 1 case of liver contusion.One case of traffic accident injury complicated with pulmonary contusion and laceration,traumatic left diaphragmatic hernia,pelvic and limb long bone fracture.Conclusions:Imaging examination was the most important means to diagnose intramural duodenal hematoma in children.Contrast-enhanced CT scan could clearly show the location and size of intramural duodenal hematoma and other substantive organ injuries which was important for clinical diagnosis and treatment.
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