Rupture of the retroperitoneal portion of the duodenum is not a frequent occurrence, but it does occur sufficiently often to be of clinical significance to those interested in the surgery of this area. Owing to the fact that such an injury frequently gives little evidence of its presence on routine exploration of the abdomen, the possibility of such an injury being present must be constantly borne in mind to prevent its being overlooked. In the hands of competent and experienced surgeons, failure to recognize such injuries has been reported, and this is particularly liable to occur when injuries to other structures are found which are thought sufficient to account for the patient's symptoms.
The duodenum is well protected from most types of abdominal assault, but, owing to its having a fixed position as it passes in front of the vertebral column, it is particularly vulnerable to compression injuries, such as
STRODE JE, GILBERT FI. Retroperitoneal Rapture of Duodenum Following Nonpenetrating Injuries to Adbomen. AMA Arch Surg. 1955;70(3):343-347. doi:10.1001/archsurg.1955.01270090021005