{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T15:53:28Z","timestamp":1775058808537,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T00:00:00Z","timestamp":1678147200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Duodenal diverticulum occurs in approximately 20% of the population and can lead to life\u2010threatening complications such as perforation. Most perforations are secondary to diverticulitis, with iatrogenic causes being exceptionally rare. This systematic review explores the aetiology, prevention and outcomes of iatrogenic perforation of duodenal diverticulum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review was performed according to the PRISMA guidelines. Four databases were searched, including Pubmed, Medline, Scopus and Embase. The primary data extracted were clinical findings, type of procedure, prevention and management of perforation and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010six studies were identified, of which 14 articles met inclusion criteria and comprised 19 cases of iatrogenic duodenal diverticulum perforation. Four cases identified duodenal diverticulum pre\u2010intervention, nine were identified peri\u2010intervention, and the remainder were identified post\u2010intervention. Perforation secondary to endoscopic retrograde cholangiopancreatography (<jats:italic>n<\/jats:italic>\u00a0=\u00a08) was most common, followed by open and laparoscopic surgery (<jats:italic>n<\/jats:italic>\u00a0=\u00a05), gastroduodenoscopy (<jats:italic>n<\/jats:italic>\u00a0=\u00a04) and other (<jats:italic>n<\/jats:italic>\u00a0=\u00a02). Operative management with diverticulectomy was the most frequent treatment (63%). Iatrogenic perforation was associated with 50% morbidity and 10% mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Iatrogenic perforation of duodenal diverticulum is exceptionally rare and associated with high morbidity and mortality. There are limited guidelines surrounding standard perioperative steps to prevent iatrogenic perforations. A review of preoperative imaging helps identify potential aberrant anatomy, such as a duodenal diverticulum, to allow for recognition and prompt management initiation in the event of perforation. Intraoperative recognition and immediate surgical repair are safe options for this complication.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.18376","type":"journal-article","created":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T17:39:13Z","timestamp":1678210753000},"page":"1322-1328","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Iatrogenic duodenal diverticulum perforation: a systematic review"],"prefix":"10.1111","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8645-9901","authenticated-orcid":false,"given":"Madison","family":"Boot","sequence":"first","affiliation":[{"name":"Department of Urology Wagga Wagga Base Hospital  Wagga Wagga New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1132-513X","authenticated-orcid":false,"given":"Kenneth","family":"Chew","sequence":"additional","affiliation":[{"name":"Department of Urology Wagga Wagga Base Hospital  Wagga Wagga New South Wales Australia"},{"name":"Doctor of Medicine University of New South Wales  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1104-4266","authenticated-orcid":false,"given":"Jack","family":"Archer","sequence":"additional","affiliation":[{"name":"Department of Urology Wagga Wagga Base Hospital  Wagga Wagga New South Wales Australia"},{"name":"Doctor of Medicine University of New South Wales  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Sowter","sequence":"additional","affiliation":[{"name":"Department of Urology Wagga Wagga Base Hospital  Wagga Wagga New South Wales Australia"},{"name":"Doctor of Medicine University of New South Wales  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Bergamin","sequence":"additional","affiliation":[{"name":"Department of Urology Wagga Wagga Base Hospital  Wagga Wagga New South Wales Australia"},{"name":"Doctor of Medicine University of New South Wales  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,3,7]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"48","article-title":"Report of a case of duodenal diverticulum containing gallstones","volume":"1710","author":"Chomel J","journal-title":"Hist. 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