(no subject)

[Sise, Mike MD]

Duodenal injuries - when to interrupt the pylorus and how to do it.
 
Difficult duodenal repair for injury to the 4th portion not involving the pancreas and remote to the ampulla. Through and through 45 caliber gunshot wound suture closure but concern for the repair. Vena cava also repaired. 12 units of pRBCs, 12 of FFP and, a 12 pack of platelets. Planning a temporary abdominal wall closure. Do you interrupt the pylorus and, if so, how do you do it.
 
Mike Sise
San Diego

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