Muhammad Ateeq, Muhammad Akram, Sikandar Hayat Gondal, Shazia Jehan, Faisal G Bhopal.
Tube duodenostomy - a safe approach for the management of 'complex duodenal injuries' in poly trauma patients.
Pak J Med Health Sci Jan ;6(1):234-7.

Though duodenal injuries are uncommon injuries but are associated with significant morbidity and mortality. A simplistic approach with primary repair with or with out tube duodenostomy is ideal for the vast majority of cases, particularly grade III, IV duodenal injuries in poly trauma patients, where as primary repair alone is recommended for uncomplicated grade I and II injuries. Complex procedure such as pyloric exclusion with or without gastrojejunostomy may be indicated for delayed treatment or severe, high grade combined pancreaticoduodenal injuries. A high index of early diagnosis and a judicious treatment plan based on a careful consideration of all the available options are essential for optimum outcome.

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