Abstract
An 83-year-old woman presented to the emergency department with a 3day history of upper abdominal pain. Computed tomography (CT) scanning showed a cyst-like mass that was 60×45 mm in size and communicated with the small intestine. The CT scan also showed free air around the mass and the surface of the liver. We diagnosed the case as peritonitis caused by perforation of the mass, and an emergency operation was performed. On laparotomy, the cyst-like mass was located 250 cm proximal to the ileocecal valve and was found to be arising from the mesenteric vessels of the native jejunal segment. Although the perforated site was not identified, we diagnosed the perforation of the mass because it was covered with pus. Partial jejunectomy including the mass was performed. Pathological examination revealed that the cyst-like mass was a true diverticulum because the wall contained all of the layers of the intestine and each structure was continuous with the jejunal structure. The abscess was found in the muscle layer, and it perforated the serosa. Therefore, we diagnosed the case as peritonitis caused by perforation of the jejunal duplication. Thus, we report a rare case of jejunal duplication with perforation in an adult.
