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Abstract
Duodenal perforation is one of the most serious surgical emergency with high mortality rate but infrequently occur due to its protected anatomical site at posterior abdominal wall surrounded by many organs , so duodenal injury is rarely isolated which increase its seriousness. Duodenum may perforate due to traumatic or non-traumatic causes. Traumatic perforation may be due blunt injury e.g. civil violence, road traffic or motor car accidents, seat-belt injury , or penetrating injury like gunshot, knife, iatrogenic injury e.g. during ERCP, nephrostomy, open or laparoscopic operations. Non-traumatic (pathological) perforation may be due to perforated peptic ulcer or perforated diverticulum. The diagnosis of duodenal perforation is difficult clinically or by simple radiographs because of its retroperitoneal site. Management of duodenal perforation is controversial depending on many factors: site and size of perforation, cause, age of patient, delay of diagnosis, general condition of the patient...etc, even conservative management of duodenal perforation have been advised and done with good success rate. Laparoscopic management of many cases of duodenal perforation had been used with success.