LAUSR

Iatrogenic ureteral injuries account for 75% of all ureteral injuries and occur primarily during urologic, gynecologic, general, vascular and gastroenterologic procedures.1 To our knowledge, no report in the literature documented ureteral injury during endoscopic gastrointestinal procedures. In this case report, we present a case of recognized Right ureteral injury during endoscopic ablation of duplicated intra-duodenal cyst with early presentation, diagnosis and management. This report highlights a rare complication during gastrointestinal procedures. A duodenal cystic lesion complicated with ureteric injury during ablation has never been reported. Case presentation Female patient 17 years old presented to our emergency with episode of acute pancreatitis three times with classical abdominal pain and elevated pancreatic enzymes. She started to recover from the last episode of acute pancreatitis but suddenly developed acute respiratory distress and desaturated significantly. Chest X-Ray revealed Acute Respiratory Distress Syndrome probably due to combination of fluid overload and pneumonia. She responded well to the medical treatment. CT abdomen and pelvis with contrast (Fig. 1A and B) showed Intraduodenal cystic lesion measuring 58 × 46 mm seen with well-defined enhancing wall seen in the second part of duodenum at the region of ampulla of Vater, in the pancreaticodudoenal groove. 3rd part of duodenum is also dilated and fluid filled. Mild ascites was seen in abdomen and pelvis. Open in a separate window Fig. 1 Image (A) CT KUB showed duplicated duodenal cysts in coronal section. Image (B) CT-KUB shows lateral view of the duplicated duodenal cysts. (See the arrows).