Pancreas-preserving duodenal resection, hepaticojejunostomy, and inferior vena cava repair for complex penetrating trauma

Abstract

Injury of the pancreaticoduodenal complex near the ampulla poses challenges for intra-operative decision making in an emergency setting. We present a rare case of penetrating abdominal trauma which resulted in injury to the second part of duodenum, intra-pancreatic common bile duct, and inferior vena cava. Inferior vena cava repair, pancreas sparing duodenal resection, Roux-en-Y hepaticojejunostomy, and gastrojejunostomy were performed with good postoperative outcomes. Technical aspects of the procedure and nuances in decision making are discussed along with relevant literature.