A Case of a Ruptured Region of the Duodenum Reconstructed with a Side-to-side Duodenojejunostomy

Abstract

A 54-year-old man was referred to our hospital with abdominal contusion due to a traffic accident. He was diagnosed as having a duodenal injury based on computed tomography, and emergency surgery was performed. During surgery, a ruptured region of the duodenum in the ligament of Treitz and bleeding from the peripheral superior mesenteric vein was found. The pancreas was undamaged. Due to the high possibility of anastomotic leakage if we attempted end-to-end anastomosis of the ruptured duodenum, we instead closed the injured part and performed a side-to-side duodenojejunostomy, gastrojejunostomy, and Braun anastomosis. The patient was discharged uneventfully on postoperative day 24. There are many procedures for resolving a damaged duodenum, so we must select the most appropriate procedure for a given case. If a diagnosis can be made early after injury and an appropriate procedure is selected, there is a better chance of achieving a good survival outcome.