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Injuries to the pancreas and duodenum present a significant challenge, for a number of reasons. First, while the deep, central position of the pancreas and duodenum afford the organs some degree of protection, their retroperitoneal location confounds the clinical detection of injury. Second, the infrequency of these injuries has resulted in a lack of significant management experience among practicing trauma surgeons. Third, anatomic and physiologic factors contribute to a disturbingly high incidence of complications following injury; morbidity is exacerbated by delays in diagnosis and treatment. Consequently, trauma to the pancreas and duodenum is associated with relatively poor outcomes that have not improved significantly, despite advances in trauma and critical care management (see Tables 32-1 and 32-2).116

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Table 32-1 Duodenal Trauma: Mortality by Mechanism of Injury in Large Series (>100 Patients)
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Table Graphic Jump Location
Table 32-2 Pancreatic Trauma: Mortality by Mechanism of Injury in Large Series (>100 Patients)

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