[Surgical treatment of open and closed injuries of the duodenum]

The article discusses a complex of methods for the diagnosis of injuries to the duodenum in 18 patients. Laboratory and X-ray findings and laparocentesis with introduction of a "feeling" catheter into the abdominal cavity with lavage of the cavity facilitated the discovery of blood and intestinal contents and allowed the correct diagnosis to be established before the operation. In inspection of the duodenum mobilization after Kocher is insufficient, in rupture of the posterior wall in the region of the inferior horizontal part the duodenum must be mobilized for its whole length. It is advisable that the defect in the duodenum is closed with a double-row suture applied with an atraumatic needle (the first inner row of interrupted sutures). The methods for applying hemostatic sutures suggested by the authors by means of created devices provide reliable hemostasis in combined injuries to the parenchymatous organs. The operation was completed by leaving glove-tube drains. The postoperative mortality was 16.6%.