[Duodenal injuries in blunt epigastric trauma (author's transl)].

The diagnostic and therapeutic problems of duodenal rupture in blunt epigastric trauma are shown in the light of 5 observations. Patients with blunt epigastric trauma must be supervised clinically for at least 48 hours in order to recognize in good time injuries of the internal organs by the increasing symptoms of peritoneal irritation. During the operation all abdominal organs are inspected and, in the event of suspected duodenal rupture, particularly the retroperitoneal wall segments are searched since the intestine is often ruptured simultaneously at several sites. Duodenoscopy during the operation accelerates the surgical exploration and is an additional safety factor. As a rule, the duodenal rupture closes without complication within the first 24 hours after suturing, while discovered too late and treated incompletely it may lead to death under the clinical picture of retroperitoneal phlegmon with septic shock; even today the overall mortality is still about 20%.