Iatrogenic duodenal diverticular perforation during a right laparoscopic nephroureterectomy: a rare complication

Abstract

Duodenal diverticulum perforation is a rare and life-threatening pathology. Perforation secondary to iatrogenic causes is rare, with only 14 cases previously reported. This paper explores a world-first case report on iatrogenic duodenal diverticulum perforation during right laparoscopic nephroureterectomy and a systematic review of all reported cases of duodenal diverticulum perforation in the literature.

Iatrogenic duodenal diverticulum perforation: a systematic review

“…Fourteen articles comprising 19 cases of iatrogenic DD perforations were identified (Table 2). 2,8–20 The studies involved included one prospective, three retrospective observational, and 10 case series/case reports, resulting in a collection of level II, III, and IV evidence as per the Oxford Centre for Evidence‐Based Medicine 21 . It is appropriate to highlight that two of the eighty patients from the prospective study were included in this study design 8…”

“…Fourteen articles comprising 19 cases of iatrogenic DD perforations were identified (Table 2). 2,[8][9][10][11][12][13][14][15][16][17][18][19][20] The studies involved included one prospective, three retrospective observational, and 10 case series/ case reports, resulting in a collection of level II, III, and IV 8 Retrospective study 3 Post ERCP complications including duodenal diverticular perforations and pancreatitis Elder 1993 9 Case report 1 Non operative management of iatrogenic duodenal diverticulum perforation post ERCP Cavanagh 1996 10 Case report 1 Non operative management of iatrogenic duodenal diverticulum perforation post T-tube cholangiography Ames 2008 11 Retrospective study 3 Imaging findings in perforated duodenal diverticulum Matsushita 2008 12 Case report 1 Conservative management of iatrogenic duodenal diverticulum perforation post ERCP Schnueriger 2008 2 Retrospective study 1 Diagnosis and surgical intervention in patients with symptomatic duodenal diverticulum Volchok 2009 13 Case report 1 Surgical management of iatrogenic duodenal diverticulum perforation post gastroduodenoscopy El-Meabch 2011 14 Case report 1 Surgical management of iatrogenic duodenal diverticulum perforation post gastroduodenoscopy Haboubi 2014 15 Case report 1 Surgical management of iatrogenic duodenal diverticulum perforation post operatively Yang 2015 16 Case Report 1 Surgical management of iatrogenic duodenal diverticulum perforation post ERCP Degheili 2017 17 Case series 1 Conservative management of iatrogenic duodenal diverticulum perforation post gastroduodenoscopy Sanchex-Haro 2020 18 Case report 1 Surgical management of iatrogenic duodenal diverticulum perforation post operatively Chew 2022 19 Case report 1 Early recognition and surgical management of iatrogenic duodenal diverticulum perforation intraoperatively…”