Surgical management of duodenal injury.
Seven patients with duodenal injuries following penetrating or blunt upper abdominal trauma are presented. In five, debridement, primary closure and drainage were performed; the postoperative course was uneventful. One other patient developed complications as a results of multiple trauma not directly related to duodenal injury. The seventh patient suffered from duodenal and small bowel fistulas, which closed after prolonged nonoperative treatment. All patients survived. Early diagnosis through accurate exploration and appropriate surgical interventions is essential to reduce morbidity and mortality in cases of serious insult to the duodenum. Debridement, primary closure (transversely in two layers) is the surgical treatment advocated. Gastroenterostomy is not recommended.