Final answer:
The preferred treatment for duodenal hematomas in children is conservative management, with IV fluids and monitoring and using CT scans for diagnosis. Surgery is only considered if there are complications or if the hematoma does not resolve with conservative treatment.
Step-by-step explanation:
The intervention of choice for duodenal hematomas after direct blunt abdominal trauma, especially in children, is typically conservative management if the patient is stable. This means monitoring the patient, ensuring they have IV access for fluids, and allowing the hematoma to resolve on its own over time. CT scans may be used to diagnose the condition and monitor its progression. Conservative treatment includes providing nourishment through routes that do not involve the mouth, such as parenteral nutrition (IV nutrition), or in some cases, via a nasogastric tube if oral intake is not possible. If there is significant blood loss, measures will be taken to replace blood volume and maintain hemodynamic stability. This approach often leads to resolution without the need for surgical intervention.
In cases where the hematoma does not resolve, or complications arise, more invasive treatments may be necessary. Procedures like the Roux-En-Y can be considered in this context. However this is generally for conditions like obesity where bariatric surgery is indicated to alter the digestive tract. In the case of a duodenal hematoma, surgery would typically only be performed if there is obstruction perforation or ongoing bleeding that does not respond to conservative measures.