# Duodenal hematoma following endoscopic duodenal biopsy in an adult requiring arterial embolization and surgical evacuation: a case report and review of the literature

## TL;DR

A 21-year-old man developed a rare complication after a duodenal biopsy, requiring embolization and surgery to treat a growing blood clot.

## Contribution

This is the first report of an enlarging duodenal hematoma managed with arterial embolization and surgical evacuation.

## Key findings

- Arterial embolization followed by laparoscopic evacuation successfully managed an enlarging duodenal hematoma.
- Surgical interventions are typically reserved for severe cases, but minimally invasive approaches may be effective.
- The case highlights a rare complication of endoscopic duodenal biopsy.

## Abstract

A 21-year-old man presented with severe abdominal pain four days after undergoing upper endoscopy with duodenal biopsies and was found to have an intramural duodenal hematoma. Symptoms progressed after attempts at diet advancement, and repeat imaging showed an enlarging hematoma with duodenal obstruction. The patient was managed with arterial embolization followed by laparoscopic surgical evacuation of the hematoma. This is the first report of an enlarging duodenal hematoma managed by this combination approach. While surgical interventions have previously been reserved for the most severe cases, we review the literature on minimally invasive approaches to manage this rare endoscopic complication.