Abstract
These two cases illustrate multiple perforations of the duodenum. The first was due to blunt external violence which caused two retroperitoneal tears in the duodenal wall and no intra-abdominal injuries. Therefore, the early picture was not typical of a rupture of a hoIIow viscus and operation was deIayed. Later the peritoneal effusion gravitated to the right Iower quadrant with Iocalized tenderness away from the site of injury. The expIoratory incision was made too Iow to visuaIize the duodenum adequateIy and the perforations were not found. Death resulted from retroperitonea1 and right pIeura1 infection, and the exact pathology was discovered at autopsy. In the second case the perforations were due to two separate duodena1 uIcers which perforated either simuItaneousIy or within a period of eight hours. At operation the second opening was discovered because of the persistent Ieakage of fluid after cIosure of the first perforation.
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