Massive right upper quadrant intra-abdominal injury requiring pancreaticoduodenectomy and partial hepatectomy.

Overview

Three cases of massive right upper quadrant abdominal injury involving liver, pancreas, and duodenum are presented. The treatment of choice for such extensive devitalizing injuries is pancreaticoduodenectomy combined with appropriate liver resection. There was no martality in this series and followup for at least 2 years shows no evidence of chronic morbidity with regard to pancreatic function. Principles of management of severe, combined injuries of organs in the upper quadrant of the abdomen are based upon rapid control of hemorrhage, repair of major vessels, pancreaticoduodenectomy when neither the head of the pancreas nor adjacent duodenum can be preserved ent-to-end inverting pancreaticojejunostomy, choledochojejunostomy and careful evaluation of the kidney and ureter.