In this study the investigators focused on duodenal perforations, requiring a tube duodenostomy and have analyzed the main features, that have influenced the surgical choices. Five patients were enrolled. Most of duodenal perforations can successfully be managed by simple repair, while complicated procedures are needed for complex injuries. Tube duodenostomy is a damage control procedure, for large duodenal perforations when further repair techniques are not recommended due to the duodenal damage, hemodynamic instability of the patient or the absence of surgical expertise for complex reconstruction.

Inclusion Criteria:

• excessive size of perforation
• extreme presence of intra-abdominal infections.

Exclusion Criteria:

• patients treated by medical therapy, endoscopic techniques, o surgical approaches

In 2 cases a tube duodenostomy was executed, due to excessive size of perforation and extreme presence of intra-abdominal infections.

In addition, other cases of duodenal injury due to other causes were treated, 3 of these requiring a tube duodenostomy approach.