Introduction
This is a rare case of repeated perforations of jejunal diverticula. To the best of our knowledge, there are only two previous similar reports ^1,2. This is however the first reported case of a recurrent perforation being treated successfully non-operatively. Jejunal diverticula are uncommon, with reported incidences at autopsy of 0.26% to 1.3%, occurring mostly after the sixth decade of life and slightly more often in men than in women. Jejunal diverticula occur on the mesenteric side of the bowel wall, which is weakened by the penetration of blood vessels ³. They are thought to be acquired pulsiondiverticula, arising as a result of motor dysfunction of the smooth muscle or the myenteric plexus in the small bowel ^4,5. The diverticula are usually distributed in the proximal jejunum ⁶, but they can be present anywhere along the small bowel and can be extensive in their distribution ⁷. A significant proportion of people with jejunal diverticula have chronic symptoms including abdominal pain after food associated with nausea, vomiting, belching, flatulence, diarrhoea, or constipation ⁸. Serious and acute complications arise less frequently and include gastrointestinal haemorrhage, perforation and intestinal obstruction, occurring in 6% to 10% of patients with jejunal diverticula ^5,7,9. Perforations occur in 2.3 to 6.4% of people with jejunal diverticula and in the majority of cases, they arise from acute necrotising inflammation, whilst blunt trauma or foreign bodies can also precipitate perforations ^4,10.