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