Abstract
A 29-year-old man was brought into the emergency room 18 hours after he received an injury to the abdomen with a physical assault. He was in a state of shock and presented muscular defense in the entire abdomen upon arrival. Abdominal and pelvic CT scans suggested a rupture in the duodenum. A subsequent emergency operation revealed a rupture encircling half of the circumference at the pancreatic face of the second and third portions of the duodenum. In addition, the duodenum around the ruptured site appeared to be severely damaged with suspicion of ischemic change. We thus avoided treating with simple closure or serosal patch using the jejunum. After localizing the ampulla of Vater from the inside of the lumen, which was away from the injury, we performed a partial resection of the affected duodenum with jejunal Roux-en-Y reconstruction. Since Roux-en-Y reconstruction offers less physical tension and requires no mobilization of the duodenum, we believe that it is a safe and feasible way of reconstruction particularly in the case of extensive injury where end-to-end anastomosis is not feasible.
