Jejunal small ectopic pancreas developing into jejunojejunal intussusception: a rare cause of ileus.
Intussusception is rare in adults. We describe a 62-year-old man with jejunal ectopic pancreas that led to jejunojejunal intussusception and ileus. The patient was admitted to our hospital because of intermittent abdominal pain. Plain abdominal radiography showed some intestinal gas and fluid levels. Abdominal CT scan demonstrated a target sign suggesting bowel intussusception. Jejunography using a naso-jejunal tube showed an oval-shaped mass about 15 mm in diameter with a smooth surface in the jejunum, which suggested a submucosal tumor (SMT), and edematous mucosa around the mass. Partial jejunal resection was carried out and the resected oval-shaped tumor, 14 mm x 11 mm in size, was found to be covered with normal jejunal mucosa. The tumor was histologically diagnosed as type III ectopic pancreas according to the classification proposed by Heinrich. Abdominal pain resolved postoperatively. This case reminds us that jejunal ectopic pancreas should be included in the differential diagnosis of intussusception caused by an SMT in the intestine.
Hirasaki
Shoji
S
Division of Gastroenterology, Kubo Hospital, 1-1-19 Uchibori, Imabari 7992116, Japan. hirasaki@icknet.ne.jp
Kubo
Motoharu
M
Inoue
Atsushi
A
Miyake
Yasuyuki
Y
Oshiro
Hisako
H
D000328:Adult; D002648:Child; D002828:Choristoma / Q000150:complications / Q000473:pathology; D003937:Diagnosis, Differential; D004724:Endoscopy; D006801:Humans; D045823:Ileus / Q000209:etiology*; D007443:Intussusception / Q000150:complications / Q000473:pathology; D007583:Jejunum / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology*
Acta Chir Belg. 2008 May-Jun;108(3):343-5
18710112
Nihon Shokakibyo Gakkai Zasshi. 2004 Jan;101(1):41-6
14763156
Intern Med. 2005 Nov;44(11):1169-73
16357455
Korean J Gastroenterol. 2003 Aug;42(2):164-7
14532722
South Med J. 1988 Oct;81(10):1264-75
3051429
Am J Gastroenterol. 1990 May;85(5):597-601
2337064
Gastrointest Endosc. 1997 Aug;46(2):172-6
9283871
J Pediatr Surg. 1990 Jun;25(6):640-3
2359000
JOP. 2007 Sep 07;8(5):584-7
17873463
Gastrointest Endosc. 2007 Nov;66(5):1026-7
17963889
Surg Gynecol Obstet. 1981 Jul;153(1):49-52
7244974
JOP. 2008 Sep 02;9(5):640-3
18762696
J Nippon Med Sch. 2007 Apr;74(2):168-72
17507794
World J Gastroenterol. 2009 Jan 28;15(4):407-11
19152443
World J Gastroenterol. 2008 Jan 28;14(4):638-40
18203302
Int Surg. 1993 Jan-Mar;78(1):32-5
8473080
JOP. 2004 Nov 10;5(6):476-9
15536284
Nihon Hoigaku Zasshi. 1997 Dec;51(6):423-9
9545755
J Formos Med Assoc. 2007 Mar;106(3):240-3
17389169