Perforation of a Giant jejunal duplication in a child - A rare cause of acute abdomen in paediatrics

Abstract

Small intestinal duplications are rare in pediatrics. Usually, they are asymptomatic but when symptoms arise, it can be nonspecific abdominal pain, melena, abdominal bloating, constipation or chronic blood loss leading to iron deficiency anemia. Rarely life-threatening complications are seen like intestinal obstruction, mucosal ulcerations, intestinal perforation and peritonitis. Diagnosis is at laparotomy in acute abdomen or during imaging. Imaging methods are ultrasound scan abdomen, Computed tomography scan of abdomen, Magnetic resonance scan of abdomen, capsule enteroscopy or technetium 99 labeled red blood cell scan.Chronic iron deficiency anemia in combination with abdominal symptoms with melena or positive stool occult blood and having negative upper and lower gastrointestinal endoscopy, must prompt further imaging as have described above.We present a pediatric jejunal duplication, which presented with chronic abdominal symptoms including melena and chronic anemia for 2 years, which was not diagnosed.Patient presented with acute abdomen due to small bowel perforation and peritonitis.

Keywords

• Chronic anemia
• Jejunal duplication
• Intestinal perforation
• Peritonitis