THE SIGNS and symptoms produced by a free perforation of a hollow viscus into the peritoneal cavity are ordinarily so typical that the diagnosis is easily suspected. However, retroperitoneal rupture of a similar viscus initiates relatively obscure symptoms and bizarre physical findings. It is not surprising, therefore, that retroperitoneal perforations of the duodenum are perplexing diagnostic problems. They are usually not diagnosed before surgical exploration and may even be overlooked at operation. In addition, these lesions are formidable problems in surgical management. For these reasons, two such cases seen at this clinic seem worthy of addition to the surgical literature.
One hundred thirty-four cases of nonpenetrating traumatic rupture of the duodenum from the world literature prior to 1910 were collected and reviewed by Guibé.1 Eighty-four additional cases between 1910 and 1940 were collected by Hinton.2 The mortality in these cases was reported as 90 and 45%, respectively. Siler
KEITH LM, BURCH BH. RETROPERITONEAL DUODENAL RUPTURE DUE TO BLUNT TRAUMA. AMA Arch Surg. 1954;69(1):81-86. doi:10.1001/archsurg.1954.01270010083012