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.