[1] Introduction
Factor XIII (FXIII) deficiency is an autosomal recessive disorder
characterized by a deficiency in FXIII, the final enzyme in the clotting
pathway. FXIII is responsible for catalyzing the cross-linking between
fibrin molecules, converting the fibrin polymer into a stable,
organized, cross-linked structure that is relatively resistant to
fibrinolysis [1-5].
In the pediatric age group, this deficiency can manifest as abnormal
bleeding from the umbilical stump, soft tissue and subcutaneous
bleeding, intracerebral hemorrhages, intraoral bleeding, and poor wound
healing. This case report details a unique presentation of FXIII
deficiency at our hospital, which was ultimately diagnosed as a large
duodenal hematoma [2]. Duodenal hematomas are themselves rare,
mostly caused by blunt abdominal trauma. Less frequently, they are
associated with bleeding disorders, as in this case, or complications of
anticoagulation therapy or endoscopy [6-9].
We present the case of a 3-year-old female who presented to the
emergency room (ER) with abdominal pain and vomiting. This case report
outlines the clinical presentation, radiological findings, and
non-surgical management of the patient.