Surgeries of duodenal diverticulization should be carried out, when a large tissue of the first part of duodenum
is lost; it includes closure of the duodenal injury, gastric antrectomy with end-to-side gastrojejunostomy, tube duodenostomy and drainage the area of duodenal repair.
 The commonest site of the perforation was at anterior wall of the first part of duodenum
.  The outcome of simple closure with omental graft was excellent as compared with definitive surgery.
Pyloroduodenotomy identified a small healed duodenal ulcer and fresh clots in the first part of duodenum
. On palpation of the third part of duodenum, a periampullary diverticulum was identified, although it was not bleeding.
Here a cholecysto--duodenal fistula following pressure necrosis of gall bladder and adjacent duodenal wall by a giant gall stone was formed; the stone slipped through fistula into the first part of duodenum
and obstructed the gastric outlet.
She underwent upper GI endoscopy, which revealed trauma at the level of the right pyriform sinus and the scope was passed up to the first part of duodenum
which showed no evidence of foreign body.
of cases % First part of duodenum
, anterior 102 98.0 Second part of duodenum, anterior wall 7 2.00 11.
The hepatic artery arises from CT and passes anteriorly and laterally below the epiploic foramen to the upper aspect of the first part of duodenum
. Its branches are Gastroduodenal artery, right gastric artery, right and left hepatic arteries.
A small perforation was found in the anterior wall of the first part of duodenum
and was repaired by closure with live omental patch.