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Spontaneous intramural haematoma of the oesophagus is an uncommon condition which may follow rapid increases in intra-oesophageal pressure and is predisposed to by coagulation disorders. The characteristic clinical presentation and findings at radiology and endoscopy frequently result in misdiagnosis and confusion with more sinister pathology. Awareness of the condition and conservative treatment with correction of coagulation abnormalities, when present, are the mainstays of management. Spontaneous resolution invariably occurs, and the condition is rarely fatal unless surgical treatment is attempted.

Although segmental bowel necrosis is a recognized complication of pancreatitis, the duodenum is rarely involved. We report a unique case of acute duodenal obstruction characterized by transmural necrosis and intramural duodenal haematoma in a young man with acute alcohol-induced pancreatitis. The patient recovered following pancreaticoduodenectorny

The literature dealing with intramural duodenal haematoma is reviewed briefly. The history of an injury followed by upper abdominal pain and signs of high small bowel obstruction is highly suggestive. A lag period between injury and onset of symptoms is typical, and X-ray contrast studies are diagnostic. A personal case is described in detail.

This paper describes a case of intramural hamatoma of the colon occurring spontancously in a patient with haemophilia so mild that the diagnosis was unsuspected before operation. Successful resection was achieved with a minimun of blood loss. During subsequent surgery, it was necessary to control bleeding with repeated infusions of cryoprecipitate.