Step I anterior vs posterior duodenum...?

[shigella123]

Duodenum has 3 parts, 1st which is horizontal and not retroperitoneal, 2nd part is vertical @ L1,2 next to the head of the pancreas, 3rd part is horizontal to abdominal aorta and superior mesenteric artery. So my question is when they say anterior part of duodenum is more likely to perforate than the posterior are they referring to the 1st part of duodenum which is not retroperitoneal?

 

[thehundredthone]

They mean the anterior (ventral) wall, usually of the first part, i.e. the duodenal bulb (where most ulcers are located). The key point with ulcers is that the anterior wall has only the abdominal cavity superficial to it so an anterior ulceration will likely perforate the viscus and set up peritonitis, whereas the posterior wall has the gastroduodenal vessels running deep to it and so a posterior ulceration will more likely perforate the vessel and bleed.