Among the large number of articles concerned with doudenal injuries, none refers to the management of wounds of the medial wall of the second portion of the duodenum. In a recent experience involving the treatment of such a wound, the approach utilized in the repair proved safe and merits presentation.
Report of a Case
A 21-year-old man was admitted to the Greenpoint Hospital in coma on Oct 8, 1967. Shortly before, he had been stabbed in the abdomen with a knife of unknown length. The pulse and blood pressure were unobtainable, and his breathing was rapid and shallow. Omentum was found protruding through a 2-cm stab wound in the left upper-abdominal quadrant. The abdomen was slightly distended and silent. Reflexes were unobtainable. Nasogastric intubation yielded fresh blood. Stool and urine specimens were normal.Prompt laparotomy was performed, and a large hemoperitoneum was evacated. The path of the knife wound is
Richter RM, Calem WS, Levowitz, MD BS. Transluminal Repair of Injuries of the Medial Wall of the Descending Duodenum. Arch Surg. 1969;98(5):652-653. doi:10.1001/archsurg.1969.01340110144020