{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:50:26Z","timestamp":1787730626820,"version":"build-2784847793"},"reference-count":72,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Traumatic injuries of the duodenum are generally rare but when they occur, they can result in serious complications. Inaccurate injury classification, delayed diagnosis, or late treatment can significantly raise morbidity and mortality. A multidisciplinary approach is often necessary. Mechanisms of injury: Isolated duodenal injuries are relatively uncommon due to the duodenum\u2019s proximity to pancreas and major vascular structures. Duodenal injuries can result from blunt or penetrating trauma. Classification: The 2019 World Society of Emergency Surgery (WSES)-American Association for the Surgery of Trauma (AAST) guidelines recommend incorporating both the AAST-OIS grading and the patient\u2019s hemodynamic status to stratify duodenal injuries into four categories: Minor injuries WSES class I, Moderate injuries WSES class II, Severe injuries WSES class III, and WSES class IV. Diagnosis: The diagnostic approach involves a combination of clinical assessment, laboratory investigations, radiological imaging and, in particular situations, surgery. Prompt diagnosis is critical because delays exceeding 24 h are associated with a higher incidence of postoperative complications and a significant rise in mortality. Contrast-enhanced abdominal computed tomography (CT) represents the gold standard for diagnosis in patients who are hemodynamically stable. Management: Duodenal trauma requires a multimodal approach that considers hemodynamic stability, the severity of the injury and the presence of associated lesions. Non-operative management (NOM) is reserved for hemodynamically stable patients with minor duodenal injuries without perforation (AAST I\/WSES I), as well as all duodenal hematomas (WSES I\u2013II\/AAST I\u2013II) in the absence of associated abdominal organ injuries requiring surgical intervention. All hemodynamically unstable patients, those with peritonitis, or with CT findings consistent with duodenal perforations or AAST grade III or higher injuries are candidates for emergency surgery. If intervention is required, primary repair should be the preferred option whenever feasible, while damage control surgery is the best choice in cases of hemodynamic instability, severe associated injuries, or complex duodenal lesions. Definitive reconstructive surgery should be postponed until the patient has been adequately resuscitated. The role of endoscopic techniques in the treatment of duodenal injuries and their complications is expanding. Conclusions: Duodenal trauma is burdened by potentially high mortality. Among the possible complications, duodenal fistula is the most common, followed by duodenal obstruction, bile duct fistula, abscess, and pancreatitis. The overall mortality rate for duodenal trauma persists to be significant with an average rate of 17%. Future prospective research needed to reduce the risk of complications following duodenal trauma.<\/jats:p>","DOI":"10.3390\/jcm15020567","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:20:37Z","timestamp":1768206037000},"page":"567","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Duodenal Trauma: Mechanisms of Injury, Diagnosis, and Management"],"prefix":"10.3390","volume":"15","author":[{"given":"Raffaele","family":"Bova","sequence":"first","affiliation":[{"name":"General, Emergency and Trauma Surgery Department, Bufalini Hospital, 47521 Cesena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7573-6290","authenticated-orcid":false,"given":"Giulia","family":"Griggio","sequence":"additional","affiliation":[{"name":"General, Emergency and Trauma Surgery Department, Bufalini Hospital, 47521 Cesena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Scilletta","sequence":"additional","affiliation":[{"name":"General, Emergency and Trauma Surgery Department, Bufalini Hospital, 47521 Cesena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Leone","sequence":"additional","affiliation":[{"name":"General, Emergency and Trauma Surgery Department, Bufalini Hospital, 47521 Cesena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9523-1324","authenticated-orcid":false,"given":"Carlo","family":"Vallicelli","sequence":"additional","affiliation":[{"name":"General, Emergency and Trauma Surgery Department, Bufalini Hospital, 47521 Cesena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanni","family":"Agnoletti","sequence":"additional","affiliation":[{"name":"Anesthesia, Intensive Care and Trauma Department, Bufalini Hospital, 47521 Cesena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5558-9965","authenticated-orcid":false,"given":"Fausto","family":"Catena","sequence":"additional","affiliation":[{"name":"General, Emergency and Trauma Surgery Department, Bufalini Hospital, 47521 Cesena, Italy"},{"name":"Department of Medical and Surgical Sciences, Bologna University, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1308\/003588414X14055925060712","article-title":"The Epidemiology of and Outcome from Pancreatoduodenal Trauma in the UK, 1989\u20132013","volume":"97","author":"Bouamra","year":"2015","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"ref_2","unstructured":"Townsend, C.M., Beauchamp, R.D., Evers, B.M., Mattox, K.L., and Sabiston, D.C. (2022). Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice, Elsevier."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.ciresp.2014.08.004","article-title":"Lesiones duodenales secundarias a traumatismo: Revisi\u00f3n de la literatura","volume":"93","author":"Santos","year":"2015","journal-title":"Cir. Esp."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Diggs, L.P., Gregory, S., and Choron, R.L. (2023). Review of Traumatic Duodenal Injuries: Etiology, Diagnosis, and Management, SAGE Publications Inc.","DOI":"10.1177\/00031348211065091"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1097\/TA.0000000000000870","article-title":"Western Trauma Association Critical Decisions in Trauma: Diagnosis and management of duodenal injuries","volume":"79","author":"Malhotra","year":"2015","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1148\/rg.286085524","article-title":"Diagnosis and Classification of Pancreatic and Duodenal Injuries in Emergency Radiology","volume":"28","author":"Linsenmaier","year":"2008","journal-title":"RadioGraphics"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1007\/s00068-023-02238-4","article-title":"Surgical management of duodenal injury: Experience from 92 cases","volume":"49","author":"Gao","year":"2023","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_8","unstructured":"Coccolini, F., Panel, W.-A.E., Kobayashi, L., Kluger, Y., Moore, E.E., Ansaloni, L., Biffl, W., Leppaniemi, A., Augustin, G., and Reva, V. (2019). Duodeno-Pancreatic and Extrahepatic Biliary Tree Trauma: WSES-AAST Guidelines, BioMed Central Ltd."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1148\/rg.2020200045","article-title":"Imaging Spectrum of Duodenal Emergencies","volume":"40","author":"Gosangi","year":"2020","journal-title":"RadioGraphics"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1186\/s13244-021-01045-y","article-title":"Duodenal imaging on the spotlight: From A to Z","volume":"12","author":"Terra","year":"2021","journal-title":"Insights Imaging"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"105","DOI":"10.4103\/TROG_20072803_105","article-title":"Spectrum and outcome of pancreatic trauma","volume":"28","author":"Kantharia","year":"2007","journal-title":"Trop. Gastroenterol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"470","DOI":"10.21037\/hbsn.2016.07.01","article-title":"Conservative and surgical management of pancreatic trauma in adult patients","volume":"5","author":"Menahem","year":"2016","journal-title":"Hepatobiliary Surg. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1016\/j.jss.2024.09.048","article-title":"A National Analysis of Pediatric Traumatic Duodenal Injuries","volume":"303","author":"Ballinger","year":"2024","journal-title":"J. Surg. Res."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Lukish, J.R., and Eichelberger, M.R. (2012). Infants and Children as Accident Victims and Their Emergency Management. Pediatric Surgery, Elsevier.","DOI":"10.1016\/B978-0-323-07255-7.00018-0"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1007\/s10140-002-0258-z","article-title":"Characteristic pancreatic injuries secondary to child abuse","volume":"10","author":"Servaes","year":"2003","journal-title":"Emerg. Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1007\/s00068-024-02506-x","article-title":"Management of pancreatic and duodenal trauma in childhood: A university hospital experience over a 10-year period","volume":"50","author":"Mansiroglu","year":"2024","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_17","first-page":"134","article-title":"Intramural duodenal hematoma and acute pancreatitis as a complication of diagnostic biopsy of a duodenal 6-year-old boy","volume":"20","author":"Krzesiek","year":"2016","journal-title":"Dev. Period Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1097\/PEC.0b013e3181887722","article-title":"Pancreatic Injury","volume":"24","author":"Waseem","year":"2008","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_19","first-page":"39","article-title":"Duodenal Hematoma following Endoscopic Duodenal Biopsy: A Case Report and Review of the Literature","volume":"20","author":"Braga","year":"2006","journal-title":"Can. J. Gastroenterol. Hepatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1055\/s-2003-39201","article-title":"Fremdk\u00f6rperingestion im Kindesalter nach Zahnarztbesuch mit der seltenen Folge einer D\u00fcnndarmperforation und Pankreasverletzung","volume":"175","author":"Hombach","year":"2003","journal-title":"R\u00f6Fo\u2014Fortschritte Auf Geb. R\u00f6ntgenstrahlen Bildgeb. Verfahr"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1097\/JTN.0b013e3181b9df54","article-title":"Duodenal Hematoma From a Fall Down the Stairs","volume":"16","author":"Terreros","year":"2009","journal-title":"J. Trauma Nurs."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.jpedsurg.2006.12.025","article-title":"Traumatic pancreatic duct injury in children: Minimally invasive approach to management","volume":"42","author":"Houben","year":"2007","journal-title":"J. Pediatr. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1016\/j.jpedsurg.2016.05.003","article-title":"Management of blunt pancreatic trauma in children: Review of the National Trauma Data Bank","volume":"51","author":"Englum","year":"2016","journal-title":"J. Pediatr. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"200","DOI":"10.7869\/tg.2012.49","article-title":"Current management of pancreatic trauma","volume":"33","author":"Kaman","year":"2012","journal-title":"Trop. Gastroenterol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s12262-011-0386-3","article-title":"Management of Pancreaticoduodenal Injuries","volume":"74","author":"Sharma","year":"2011","journal-title":"Indian J. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"021","DOI":"10.1055\/s-0035-1554985","article-title":"Pancreatic and Duodenal Trauma in Children","volume":"04","author":"Lesher","year":"2015","journal-title":"J. Pediatr. Intensiv. Care"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/S0020-1383(01)00099-7","article-title":"Management of penetrating pancreatic trauma: An 11-year experience of a level-1 trauma center","volume":"32","author":"Vasquez","year":"2001","journal-title":"Injury"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1111\/j.1445-2197.2005.03351.x","article-title":"Pancreatic and duodenal injuries: Keep it simple","volume":"75","author":"Rickard","year":"2005","journal-title":"ANZ J. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1097\/TA.0000000000004303","article-title":"The impact of postoperative enteral nutrition on duodenal injury outcomes: A post hoc analysis of an Eastern Association for the Surgery of Trauma multicenter trial","volume":"97","author":"Choron","year":"2024","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e4104509","DOI":"10.25100\/cm.v52i2.4509","article-title":"Damage control in penetrating duodenal trauma: Less is better","volume":"52","author":"Parra","year":"2021","journal-title":"Colomb. Medica"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.ijsu.2007.05.006","article-title":"Injuries to the duodenum\u2014Prognosis correlates with body Injury Severity Score: A prospective study","volume":"5","author":"Rathore","year":"2007","journal-title":"Int. J. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Ferrada, P., Wolfe, L., Duchesne, J., Fraga, G.P., Benjamin, E., Alvarez, A., Campbell, A., Wybourn, C., Garcia, A., and Morales, C. (2019). Management of Duodenal Trauma: A Retrospective Review from the Panamerican Trauma Society, Lippincott Williams and Wilkins.","DOI":"10.1097\/TA.0000000000002157"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1097\/TA.0000000000001604","article-title":"Penetrating injuries to the duodenum: An analysis of 879 patients from the National Trauma Data Bank, 2010 to 2014","volume":"83","author":"Phillips","year":"2017","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Bolaji, T., Ratnasekera, A., and Ferrada, P. (2023). Management of the Complex Duodenal Injury, Elsevier Inc.","DOI":"10.1016\/j.amjsurg.2022.12.016"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1177\/0003134821995054","article-title":"Contemporary Management of Traumatic Duodenal Injuries","volume":"89","author":"Butano","year":"2021","journal-title":"Am. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1148\/rg.286075141","article-title":"Traumatic Retroperitoneal Injuries: Review of Multidetector CT Findings","volume":"28","author":"Daly","year":"2008","journal-title":"RadioGraphics"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"rjab610","DOI":"10.1093\/jscr\/rjab610","article-title":"Duodenal transection following blunt abdominal trauma: A case report and literature review","volume":"2022","author":"Alkhulaiwi","year":"2022","journal-title":"J. Surg. Case Rep."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1097\/00005373-200110000-00004","article-title":"Role of Duodenography in the Diagnosis of Blunt Duodenal Injuries","volume":"51","author":"Timaran","year":"2001","journal-title":"J. Trauma Inj. Infect. Crit. Care"},{"key":"ref_39","first-page":"424","article-title":"Blunt and Penetrating Injury to the Bowel: A Review","volume":"37","author":"Kenny","year":"2023","journal-title":"Clin. Colon Rectal Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/j.amjsurg.2012.12.003","article-title":"Diagnosing blunt hollow viscus injury: Is computed tomography the answer?","volume":"205","author":"Joseph","year":"2013","journal-title":"Am. J. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1148\/radiol.2492072055","article-title":"Surgically Important Bowel and\/or Mesenteric Injury in Blunt Trauma: Accuracy of Multidetector CT for Evaluation","volume":"249","author":"Atri","year":"2008","journal-title":"Radiology"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.2214\/ajr.160.6.8498221","article-title":"Duodenal injuries caused by blunt abdominal trauma: Value of CT in differentiating perforation from hematoma","volume":"160","author":"Kunin","year":"1993","journal-title":"Am. J. Roentgenol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1097\/00005373-200006000-00002","article-title":"Magnetic Resonance Cholangiopancreatography (MRCP) in the Assessment of Pancreatic Duct Trauma and Its Sequelae: Preliminary Findings","volume":"48","author":"Fulcher","year":"2000","journal-title":"J. Trauma Inj. Infect. Crit. Care"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1177\/0284185114529949","article-title":"Evaluation of diagnostic utility of multidetector computed tomography and magnetic resonance imaging in blunt pancreatic trauma: A prospective study","volume":"56","author":"Panda","year":"2015","journal-title":"Acta Radiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s10140-009-0811-0","article-title":"Imaging of blunt pancreatic trauma","volume":"17","author":"Rekhi","year":"2009","journal-title":"Emerg. Radiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s13017-024-00537-8","article-title":"The 2023 WSES guidelines on the management of trauma in elderly and frail patients","volume":"19","author":"Chouillard","year":"2024","journal-title":"World J. Emerg. Surg."},{"key":"ref_47","first-page":"CD007370","article-title":"Prophylactic antibiotics for penetrating abdominal trauma","volume":"2019","author":"Brand","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Herrod, P.J., Boyd-Carson, H., Doleman, B., Blackwell, J., Williams, J.P., Bhalla, A., Nelson, R.L., Tou, S., and Lund, J.N. (2019). Prophylactic Antibiotics for Penetrating Abdominal Trauma: Duration of Use and Antibiotic Choice, John Wiley and Sons Ltd.","DOI":"10.1002\/14651858.CD010808.pub2"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/j.jss.2024.07.119","article-title":"Management of Traumatic Duodenal Injury: Is There a Role for Early Parenteral Nutrition?","volume":"302","author":"Vira","year":"2024","journal-title":"J. Surg. Res."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Choron, R.L., and Efron, D.T. (2018). Isolated and Combined Duodenal and Pancreatic Injuries: A Review and Update, Springer.","DOI":"10.1007\/s40137-018-0216-7"},{"key":"ref_51","unstructured":"Sermonesi, G., Tian, B.W.C.A., Vallicelli, C., Abu-Zidan, F.M., Damaskos, D., Kelly, M.D., Lepp\u00e4niemi, A., Galante, J.M., Tan, E., and Kirkpatrick, A.W. (2013). Cesena Guidelines: Wses Consensus Statement on Laparoscopic-First Approach to General Surgery Emergencies and Abdominal Trauma, BioMed Central Ltd."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.injury.2015.10.003","article-title":"Indirect signs of blunt duodenal injury on computed tomography: Is non-operative management safe?","volume":"47","author":"Bradley","year":"2016","journal-title":"Injury"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1007\/s00068-007-7078-5","article-title":"Duodenal injuries: A review","volume":"33","author":"Ivatury","year":"2007","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1097\/TA.0000000000000214","article-title":"Complex penetrating duodenal injuries: Less is better","volume":"76","author":"Parra","year":"2014","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s13017-021-00352-5","article-title":"Evidence for use of damage control surgery and damage control interventions in civilian trauma patients: A systematic review","volume":"16","author":"Bobrovitz","year":"2021","journal-title":"World J. Emerg. Surg."},{"key":"ref_56","unstructured":"Kaban, J.M., Parry, N., and Gross, R.I. (2021). Advanced Trauma Operative Management, American College of Surgeons. [3rd ed.]."},{"key":"ref_57","first-page":"829","article-title":"A ten-year retrospective review: Does pyloric exclusion improve clinical outcome after penetrating duodenal and combined pancreaticoduodenal injuries?","volume":"62","author":"Seamon","year":"2007","journal-title":"J. Trauma Inj. Infect. Crit. Care"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s13017-023-00494-8","article-title":"Risk factors for the leakage of the repair of duodenal wounds: A secondary analysis of the Panamerican Trauma Society multicenter retrospective review","volume":"18","author":"Sanchez","year":"2023","journal-title":"World J. Emerg. Surg."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1097\/TA.0000000000003972","article-title":"Outcomes among trauma patients with duodenal leak following primary versus complex repair of duodenal injuries: An Eastern Association for the Surgery of Trauma multicenter trial","volume":"95","author":"Choron","year":"2023","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"de Carvalho, M.E.A.J., and Cunha, A.G. (2020). Pancreaticodudonectomy in Trauma: One or Two Stages?, Elsevier Ltd.","DOI":"10.1016\/j.injury.2020.01.018"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"111721","DOI":"10.1016\/j.injury.2024.111721","article-title":"Pancreaticoduodenectomy in high-grade pancreatic and duodenal trauma","volume":"55","author":"Noorbakhsh","year":"2024","journal-title":"Injury"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"4839","DOI":"10.1007\/s00464-024-11133-x","article-title":"Endoscopic repair of duodenal perforations, a scoping review","volume":"38","author":"Williams","year":"2024","journal-title":"Surg. Endosc."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1159\/000494967","article-title":"Gastric Outlet Obstruction due to Intramural Duodenal Hematoma after Endoscopic Biopsy: Possible Therapeutic Role of Endoscopic Dilation","volume":"12","author":"Samra","year":"2018","journal-title":"Case Rep. Gastroenterol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"874","DOI":"10.15537\/smj.2020.8.25128","article-title":"Endoscopic dilatation as a new technique in managing pediatric duodenal hematoma","volume":"41","author":"Alharbi","year":"2020","journal-title":"Saudi Med J."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"2243","DOI":"10.3748\/wjg.v28.i20.2243","article-title":"Endoscopic management of intramural spontaneous duodenal hematoma: A case report","volume":"28","author":"Valerii","year":"2022","journal-title":"World J. Gastroenterol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"832","DOI":"10.5946\/ce.2024.117","article-title":"Successful iatrogenic duodenal perforation treatment with endoscopic hand suturing","volume":"57","author":"Spychalski","year":"2024","journal-title":"Clin. Endosc."},{"key":"ref_67","first-page":"64","article-title":"Endoscopic management of duodenal fistula in a patient operated after abdominal injury","volume":"92","author":"Bednarski","year":"2020","journal-title":"Pol. J. Surg."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"rjaf955","DOI":"10.1093\/jscr\/rjaf955","article-title":"Complete duodenal disruption from blunt abdominal trauma successfully managed with multistage surgical and endoscopic interventions: A case report","volume":"2025","author":"Yong","year":"2025","journal-title":"J. Surg. Case Rep."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"10542","DOI":"10.3748\/wjg.v21.i37.10542","article-title":"Endoscopic management of gastrointestinal perforations, leaks and fistulas","volume":"21","author":"Rogalski","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/S1072-7515(98)00205-1","article-title":"Delayed Diagnosis of Blunt Duodenal Injury: An Avoidable Complication","volume":"187","author":"Allen","year":"1998","journal-title":"J. Am. Coll. Surg."},{"key":"ref_71","first-page":"61","article-title":"Management of duodenal trauma","volume":"14","author":"Chen","year":"2011","journal-title":"Chin. J. Traumatol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1016\/0011-3840(93)90063-M","article-title":"Management of duodenal injuries","volume":"30","author":"Asensio","year":"1993","journal-title":"Curr. Probl. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/567\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:34:48Z","timestamp":1768206888000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/567"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,10]]},"references-count":72,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jcm15020567"],"URL":"https:\/\/doi.org\/10.3390\/jcm15020567","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,10]]}}}