[Bleeding secondary duodenal diverticulum: a rare late complication following nephrolithotomy]

Secondary duodenal diverticula are due primarily to traction upon that section from some other cause such as ulcer, cholecystitis and so forth. It accounts for 1.6 to 20% of all duodenal diverticula. Numerous reports of gastrointestinal hemorrhage from duodenal diverticula have appeared in the literature. But massive UGI bleeding due to secondary duodenal diverticulum, caused by nephrolithotomy, was a rare late complication. Here we present a case of a 63-year-old male patient who underwent a right side nephrolithotomy 10 and 8 years previously, then developed massive UGI bleeding suddenly. Pre-operative UGI series and gastroscopy showed chronic duodenal ulcer and duodenal diverticulum at second section where much blood clot was noted. In time, a successful operation was performed. This complication of secondary duodenal diverticulum was rare, so consideration regarding management and surgical approach was discussed.