Duodenal perforation in blunt abdominal trauma.

Ten patients with duodenal perforation secondary to blunt abdominal trauma are reviewed. All 10 patients survived. Most of the injuries were related to motor vehicle accidents. Early recognition requires a high index of suspicion because preoperative signs and symptoms tend to be nonspecific and x-rays are usually not helpful. A careful exploration of the duodenum at laparotomy including both the Kocher maneuver and the Cattell-Braasch exposure is essential. Suitable methods of surgical repair are numerous, but those providing for restoration of normal gastrointestinal tract continuity are preferred.