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May 1968

Combined Duodenal Pancreatic Trauma: The Role of End-to-Side Gastrojejunostomy

Author Affiliations

Los Angeles
From the Department of Surgery, University of Southern California and Los Angeles County Hospital, Los Angeles.

Arch Surg. 1968;96(5):712-722. doi:10.1001/archsurg.1968.01330230020004

COMBINED injuries of the duodenum and pancreas present surgical problems of a very high order of magnitude. Burrus et al1 reported 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 Glas2 in a review of the literature found that death occurred in eight of 11 reported patients with combined duodenal-pancreatic injury. Cleveland et al3 reported 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.4 The 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