Primary adenocarcinoma of the duodenum is rare. An extensive experience with fiberoptic esophagogastro‐duodenoscopy in our institution has indicated that duodenal neoplasms may be more frequent than suspected and are readily diagnosed by this modality. With this in mind, clinical, pathological, diagnostic and therapeutic aspects of the 71 patients with primary carcinoma of the duodenum reported in the literature in the last 10‐year period, 1965–1974, were reviewed. It would appear that fiberoptic endoscopy of the upper gastrointestinal tract should become the major diagnostic tool for this disease. It enables biopsies, brushings and washings to be taken. A preoperative histological diagnosis ensures that both patient and surgeon can be prepared for major abdominal surgery. It is imperative that during the endoscopic examination, the entire duodenum be examined. Pancreatico‐duodenectomy appears to offer the best chance of long term survival in patients whose lesion is resectable. The role and value of adjuvant chemo‐ and radiotherapy is still to be determined.

Spontaneous rupture of the common bile duct is an extremely rare condition. Only 11 cases have been reported in the world literature. An unusual case of this complication is reported and the possible etiology and pathogenesis are discussed.

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