New technique for the management of duodenal injuries.

During a 3 years period (April 1983 to March 1985), 8 patients with duodenal injury (Table) were managed operatively in the South Surgical Unit of Mayo Hospital. Duodenal perforation were repaired in 7 patients while in 1, who had a duodenal wall haematoma was treated expectantly. Nasojejunal feeding tube were introduced at operation in 7 patients in addition to nasogastric tubes for decompressing the stomach. Two of these patients developed Fistulae which closed spontaneously while the patients were maintained on jejunal feeding. A nasojejunal tube was introduced under radiological control after the development of a duodenal Fistula in 1 patient. In this patient the Fistula also closed spontaneously while jejunal tube feeding was maintained. One other patient with duodenal and inferior vena caval tear died as a result of secondary haemorrhage which coincided with the development of a duodenal Fistula. A nasojejunal tube was not used in this patient.