In this case report a 48-year-old man presented with nausea and abdominal pain. Ten days prior he had been treated with an endoscopic epinephrine/saline injection for haemostasis of a bleeding duodenal ulcer and was discharged the following day. At readmission, an abdominal CT revealed severe gastric distention and a gastroscopy showed total duodenal obstruction. Subsequent post-contrast CT revealed that a massive intramural duodenal haematoma was the cause of the total duodenal occlusion. Also, acute pancreatitis was seen. The treatment was conservative, and follow-up gastroscopy showed total resolution of the haematoma.