A Case of Traumatic Duodenal Injury Successfully Treated with Subtotal Stomach-preserving Duodenal Diverticularization

Abstract

A 46-year-old woman fell while riding a bicycle and suffered an abdominal handlebar injury. She visited our hospital presenting with abdominal pain. Duodenal injury was detected by computed tomography (CT). She underwent an emergency laparotomy immediately. We detected duodenal injuries and perforations of the inferior and posterior descending walls that were closed with simple sutures. Because stenosis was anticipated, we performed a subtotal stomach-preserving duodenal diverticularization. No major postoperative complications occurred. The patient was discharged on postoperative day 22. A simple primary closure is usually performed for traumatic duodenal injuries ; however, if the injury is complicated and a patient's vital signs are stable, we consider additional operative procedures such as duodenal diverticularization. In this case, we performed duodenal diverticularization and preserved the subtotal stomach with no major complications. Our findings suggest that this may be a valid option for complicated duodenal injuries.