“The overall incidence of duodenal injuries in severely injured trauma patients is between 0.2 to 0.6% and the overall prevalence in those suffering from abdominal trauma is 3 to 5% 1,2. Approximately 80% of these cases are secondary to penetrating trauma, commonly associated with vascular and adjacent organ injuries. These associated injuries create a significant challenge towards the early diagnosis and appropriate management. Therefore, defining the best surgical treatment algorithm remains controversial. Mild to moderate duodenal trauma is currently manage via primary repair and simple surgical techniques. However, severe injuries have required complex surgical techniques (duodenal diverticulization, pyloric exclusion with or without gastrojejunostomy and pancreatoduodenectomy) without significant favorable outcomes and consequential increase in the rates of mortality.”