Combined Duodenal Pancreatic Trauma

COMBINED injuries of the duodenum and pancreas present surgical problems of a very high order of magnitude. Burrus et al1reported that postoperative complications developed in 40% of patients with combined duodenal and pancreatic injuries, whereas when the duodenum alone was injured such complications developed in only 10% of patients. Kerry and Glas2in a review of the literature found that death occurred in eight of 11 reported patients with combined duodenal-pancreatic injury. Cleveland et al3reported the death of five of six patients with combined duodenal and pancreatic injury. In a review of patients with duodenal trauma treated at the Los Angeles County Hospital, the serious nature of combined duodenal and pancreatic injury was also noted.4The mortality in 20 patients with duodenal perforation without pancreatic injury was 5%, that in nine with associated pancreatic injury, 33%. Regional complications that developed in the latter patients