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Ahmad H, Haider J, Siddiqui SS, et al. Iatrogenic Non-Reconstructable Duodenal Injury Presenting without Peritonitis: An Indication of Pancreatoduodenectomy in the Presence of Safe Hands. A Case Report. Cureus. 2017;9(4):e1138doi: 10.7759/cureus.1138.
Ahmad, H., Haider, J., Siddiqui, S. S., Naz, S., & Alam, S. N. (2017). Iatrogenic Non-Reconstructable Duodenal Injury Presenting without Peritonitis: An Indication of Pancreatoduodenectomy in the Presence of Safe Hands. A Case Report. Cureus, 9(4), e1138. https://doi.org/10.7759/cureus.1138
Ahmad, Humaid, et al. "Iatrogenic Non-Reconstructable Duodenal Injury Presenting without Peritonitis: An Indication of Pancreatoduodenectomy in the Presence of Safe Hands. A Case Report." Cureus vol. 9,4 (2017): e1138. doi: https://doi.org/10.7759/cureus.1138
Ahmad H, Haider J, Siddiqui SS, Naz S, Alam SN. Iatrogenic Non-Reconstructable Duodenal Injury Presenting without Peritonitis: An Indication of Pancreatoduodenectomy in the Presence of Safe Hands. A Case Report. Cureus. 2017 Apr 06;9(4):e1138. doi: 10.7759/cureus.1138. PMID: 28484677; PMCID: PMC5419819.
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Cureus. 2017 Apr 06;9(4):e1138. doi: 10.7759/cureus.1138.

Iatrogenic Non-Reconstructable Duodenal Injury Presenting without Peritonitis: An Indication of Pancreatoduodenectomy in the Presence of Safe Hands. A Case Report.

Cureus

Humaid Ahmad, Jahanzaib Haider, Sheeraz S Siddiqui, Sumbul Naz, Shams Nadeem Alam

Affiliations

  1. Department of Surgery / Hepatopancreatobiliary and Liver Transplant Unit, Dow University of Health Sciences (DUHS), Karachi, Pakistan.
  2. Department of Surgery, Dow University of Health Sciences (DUHS), Karachi, Pakistan.
  3. Hepatopancreatobiliary and Liver Transplant Unit, Dow University of Health Sciences (DUHS), Karachi, Pakistan.

PMID: 28484677 PMCID: PMC5419819 DOI: 10.7759/cureus.1138

Abstract

Iatrogenic duodenal injuries are rare complications of upper gastrointestinal endoscopic procedures, gallbladder, and right kidney operations. Management includes diverse options depending on a number of factors that include the size of the injury, timing of presentation, degree of peritoneal contamination, and presence of peritonitis and/or sepsis, etc. While most duodenal injuries are small, large complex non-reconstructable injuries may occasionally occur, requiring complex surgical procedures rather than primary repair which if done in the latter cases, may lead to further morbidity and mortality. Whipple's pancreatoduodenectomy has rarely been performed for complex duodenal injuries especially in the iatrogenic setting. Here a case is reported of an iatrogenic duodenal injury that presented 12 days after a right open nephrectomy, with a dehisced right lumber incision having greater than one liter per day bilious discharge, for which Whipple's pancreatoduodenectomy was performed. A discussion regarding factors which influenced per-operative decision making and probably led to a successful patient outcome is presented.

Keywords: duodenal injury; iatrogenic duodenal injuries; iatrogenic injury; pancreatoduodenectomy; post-nephrectomy complications

Conflict of interest statement

The authors have declared that no competing interests exist.

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