Duodenal injuries.

The lethal potential of duodenal trauma relates to the severity of the defect, associated injuries, expedient diagnosis, and adequacy of repair. A high index of suspicion must be used in patients sustaining blunt abdominal trauma. An aggressive approach to penetrating abdominal trauma will detect the majority of duodenal injuries in a timely fashion. The unique anatomic and physiologic characteristics of the duodenum demand careful selection of the operative repair to fit the injury. A classification scheme is reviewed that should help the surgeon select the appropriate procedure from a multitude of choices. Standard postoperative care is required. Adherence to these principles should result in acceptable morbidity and mortality in patients with duodenal injuries.