Report of a Case of Duodenal Perforation Following Laparoscopic Ureterolithotomy

Despite the development of non-invasive methods of treating stones of urinary tract، surgery is still needed in some cases، indicated. Even in these cases، non invasive surgical procedures، such as laparoscopy، is preferred. In this article we are going to report on the case of a person who underwent laparoscopic management for his proximal ureterolithiasis، and which resulted in a rare complication of this therapeutic procedure; duodenal perforation. The patient is a 49-years old man that a few days after undergoing laparoscopic treatment، referred with acute abdominal symptoms. The laparatomy revealed traumatic duodenal perforation that was repaired. Persistent abdominal pain obligated the performance of an imaging study، which identified a loci of fluid accumulation in the anterior aspect of the right ureter. Trying to resolve the fluid accumulation، a CT-guided pigtail was embedded. Fistulography was performed. The source of fluid accumulation was attributed to the leakage of the repaired duodenum. During the treatment course an enterocutaneous fistula appeared. Duodenal injury is one of the very rare complications of laparoscopic ureterolithotomy، which should be considered in those presenting by acute abdominal pain after a laparoscopic intervention. Therefore due to the difficulty of duodenal injury management، care is neededduring laparoscopic interventions.