Over a 15-year period, 967 children presenting to Red Cross War Memorial Children's Hospital with blunt abdominal trauma included nine cases in whom traumatic intramural duodenal haematomas were diagnosed on clinical and radiological grounds. Motor vehicle collisions were the commonest cause of injury. Review of these nine cases and their management confirms the efficacy of non-operative treatment and that laparotomy should be reserved for only those children with additional intra-abdominal injuries, or where the diagnosis remains in doubt.