Background
The diverticulum of the duodenum is the second most common location
after the colon 1. Most patients are asymptomatic.
However, among complications, duodenal diverticula perforation (DDP)
rarely occurs, but when it does, it often perforates the
retroperitoneum. Furthermore, bezoar-induced DDP in duodenal diverticula
is substantially rare 2. DDP is the most threatening
complication, and appropriate treatments for perforated duodenal
diverticula remain unclear, ranging from conservative therapy to
surgery, including pancreatoduodenectomy. Surgical intervention may
increase morbidity and mortality rates. Therefore, non-operative
management can be considered in some patients with perforated
diverticulum who have stable vital signs without generalized peritonitis
or in elderly patients with comorbidities 3. Recently,
several cases of conservative treatment with endoscopy have been
reported. We are describing the successful endoscopic drainage and
lithotripsy of a DDP associated with an impacted bezoar.