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Ileal diverticulum, Perforation, Non-Meckel’s, Occupational hazard, ectopic, gastric and pancreatic tissues
The incidence of non-Meckel small bowel diverticulosis is rare. It is less than 1% of the population. Duodenum is the commonest site, followed by jejunum and rarely ileum. The causes of Ileal perforation are many. According to literature the commonest cause is spontaneous ileal perforation. Other causes are tuberculosis, typhoid, lymphoma, immunocompromised conditions, trauma, long standing steroid therapy and bowel obstruction. Non-Meckel Small bowel diverticula in the majority are false diverticula as they lack muscular wall which true diverticulum possesses.
The incidence of ileal diverticular perforation is rare. In our case, it was due to continuous compression by the patient on a pneumatic power drill against the abdominal wall in Valsalva manoevre as part of patient’s occupation. This resulted in perforation of an already existing, asymptomatic ileal diverticulum, and presented as an acute abdomen. The patient underwent resection- anastamosis of the ileal segment, which on biopsy revealed a diverticum with gastric and pancreatic tissue.
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