Surgical affections of the duodenum

ABSTRACT

From April, 1995 to July, 1997, 18 consecutive patients with surgical diseases of the duodenum excluding perforated duodenal ulcer requiring an omental patch were managed in West Surgical Unit of Mayo Hospital, Lahore. Trauma [blunt or penetrating] was the most common affection. Time lag between injury and operation was the most important factor prognostically followed by the severity of injury. There was a random mortality of 33% rising to 65% after formation of duodenal fistula. T-tube duodenostomy, sump drainage and TPN may be the pillars of management of late, extensive or complicated duodenal surgery. Of the six patients who died in all, five of them did so due to trauma. "Treatment policies" should be overruled by individual case assessment where required