Jejunal duplication presenting with perforation peritonitis: Complication of a rare congenital malformation in an elderly female

Intestinal duplication is a rare congenital malformation that is usually detected or becomes symptomatic in early paediatric age and is rarely reported in adults. The ileum is the most frequent site, while jejunum is rarely involved. Features are often nonspecific, hence difficult to diagnose. Ultrasonography is often preferred imaging method. The surgical procedure is determined depending on the presentation. We present a case of an adult female presenting with perforation peritonitis. Intraoperatively, approximately 6 cm length communicating jejunal tubular duplication over the mesenteric margin was found, with perforation involving the duplication segment and normal jejunum. Resection of jejunal duplication segment and anastomosis was carried out. This presentation proposed further insight into enteric duplication and their clinical presentations, along with emphasis on how and why this entity was missed preoperatively and came out to be an intra-operative surprise.