Primary repair in transection of duodenum with avulsion of the common duct.

In combined pancreatoduodenal trauma, the surgeon usually chooses a diverting or resectional procedure at substantial risk. Simple closure of the duodenum and transposition of the common duct was accomplished at early operation in an 18-year-old boy who had almost complete transection of the duodenum with avulsion of the ampulia of Vater from blunt abdominal trauma. Transgastrojejunostomy and use of Chaffin tubes were discontinued prior to discharge from the hospital three weeks later. The postoperative course was complicated only by a brief pancreatitis. The excellent result persists more than two years later. In similar anatomic situations, consideration might be given to this operative approach.