Surgical treatment of duodenal trauma

Abstract

Duodenal injury remains to be a lethal injury. The high mortality and complication rates are due to difficulties in diagnosis resulting in delayed recognition and associated injuries such as pancreatic injury and retroperitoneal vascular injuries. Diagnosis can be done perioperatively or intraoperatively. Importantly, clinical judgments have to be based on the combination of mechanisms, clinical signs, and radiological evaluations if possible. In the operation, the strategy is usually simple including primary repair and omentum patch. Nevertheless, if more complicated procedures are required, the principles of damage control surgery need to be followed since definitive repair can be performed later. Although conservative treatment is possible, surgeons need to be aware of alternative options available.