We present our experience on pancreato-duodenal trauma surgically treated; we have studied the etiopathogenesis of the lesions and the severity of the condition, which is related to their anatomical relationships and to the difficulties of the early diagnosis. We emphasize the value of non invasive diagnostic methods, particularly immediate ultrasonography, CAT and exceptionally RECP. Abdominocentesis with peritoneal lavage and the insertion of a catheter through a minimal jejunostomy, for the nutritional support of the patient and to prevent complications merits special mention.