- Conservative management is a viable option for duodenal obstruction from retroperitoneal hematoma in hemodynamically stable pediatric patients without active bleeding or ischemia.
- Close monitoring is essential, including clinical exam, nasogastric output, and selective imaging to detect worsening obstruction or complications.
- High nasogastric output and delayed bowel function can signal obstruction; total parenteral nutrition may be required until resolution.
- Avoid unnecessary radiation exposure in children—use imaging judiciously and rely on clinical indicators when possible.
- Escalate to intervention (percutaneous or surgical) if symptoms persist, worsen, or complications such as ischemia, infection, or pancreatitis develop.
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