[Surgical treatment of peroperative injuries of the duodenum]

Operative duodenal lesions are rare, but often fatal complications of certain abdominal procedures. This was reported in small series with an incidence of 0.2% of all abdominal operations. The management of these injuries requests the surgeon to be familiar with a number of specific operative approaches, which are to be used according to the operative situation. In the 1985-1992, year period, 21 cases of the operative injury of duodenum were managed without mortality, and with 3 cases of transient postoperative fistula, which healed spontaneously. The most important factors in the management of this complication are the early operative recognition of duodenal injury, or early reoperation, if, in a case of duodenal fistula, distal outflow is considered insufficient. The particularities of the duodenal suture and perioperative treatment are to be well understood. Roux en Y covering of the duodenal defect by open jejunal loop is the best method in management of these injuries.