Over-the-scope clip closure for penetrating duodenal injury after cryotherapy for renal cell carcinoma.

Gastrointestinal injury is a rare complication of renal cryoablation. In this report, we present a case of penetrating duodenal injury following renal cryoablation that was successfully managed with over-the-scope clip closure. A 92-year-old male patient was referred to our hospital after sustaining a penetrating duodenal injury caused by percutaneous cryotherapy for renal cell carcinoma. The patient had undergone computed tomography-guided percutaneous cryotherapy for right renal cell carcinoma 1 month previously. Follow-up computed tomography suggested a duodenal injury, although no abdominal symptoms were evident. Esophagogastroduodenoscopy revealed a full-thickness duodenal defect. He underwent endoscopic suturing for the duodenal injury using an over-the-scope clip system. The patient's clinical course following treatment was uneventful. Gastrointestinal injury can be a rare complication of cryotherapy for renal cell carcinoma, and this case suggests the potential utility of the over-the-scope clip system for the complete closure of a penetrating duodenal injury after renal cryoablation.