In type I gastric injury, a limited resection with a gastroduodenal reconstruction is relatively simple to perform. The strictures are short, and hence the extent of gastric resection required is minimal. The stomach and the duodenum can be brought together in most instances without tension. Type II or III gastric injury is best treated by a distal gastrectomy and an antecolic Polya reconstruction. A type V gastric injury that extends into the duodenum or has a separate stricture of the duodenum is more difficult to manage. Resection in such instances involves a major procedure in a patient with poor general condition. Such injuries are best managed by an antecolic dependant gastrojejunostomy.