AN EPISODE of severe blunt abdominal trauma caused extensive destruction of the duodenum with avulsion of the head of the pancreas, distal common duct, and ampulla of Vater from the duodenum. A pancreatoduodenectomy was required to repair the injury. Successful repair of such an extensive injury is rare, and the present case is the third reported in the literature and the fifth known instance (A. P. Thai, written communication to the author, December 1966) of pancreatoduodenectomy for pancreatoduodenal trauma. Report of a Case A 16-year-old white boy was admitted to Parkland Memorial Hospital on Aug 23, 1966, after a motorcycle accident in which he sustained a heavy blow to the upper abdomen. After several hours, during which minimal symptoms were noted, he began to vomit blood and have upper abdominal pain. On physical examination, his blood pressure was 130/90 mm Hg; temperature, 99 F (37.2 C); pulse rate, 100 beats/min;