A Jacobz, A Nawaz, H Matta, A Al Salem, Intussusception Secondary to Isolated Heterotopic Pancreas of the Ileum: Case Report and Review of the Literature. 2002; 22(3-4): [213][214][215] Intussusception in the pediatric age group is usually idiopathic in origin, and in a small number of patients ranging from 2% to 12%, a pathological lesion as a leading point is identifiable. [1][2][3][4] Of the variety of pathologcial lesions identified as leading points for intussusception, Meckel's diverticulum is the most common, and very rarely, isolated heterotopic pancreas of the ileum.5 This is a case report of intussusception in an infant caused by an isolated heterotopic pancreas of the ileum. The literature on the subject is also reviewed. Case ReportAn 11-month-old male infant was admitted to the hospital because of abdominal pain, fever and vomiting of two hours' duration. The infant had had diarrhea the day prior to admission, and while in hospital, he had passed one bloody stool. Clinically, he was mildly dehydrated, and no masses could be felt on abdominal examination. The possibility of intussuscpetion was raised, and this was confirmed by an abdominal ultrasound. A contrast enema revealed intussusception as far as the splenic flexure, and was partially reduced under fluroscopic control.The patient had a laparotomy through a transverse, muscle-splitting incision in the right iliac fossa. The intussusception was reduced manually, and while examining the small intestine, a small polyp was found in the distal ileum. This was excised via a small enterotomy, which was closed transversely. Postoperatively, the patient did well and was discharged home on the sixth postoperative day. Histology of the resected polyp (Figures 1 and 2) revealed a 1 cm polypoid tissue covered with a flat, severely inflamed and ulcerated intestinal mucosa. In the underlying stroma were abundant glandular ductal structures resembling those in the pancreas and surrounded by slightly irregular thin-walled blood vessels. Among the glandular structures were streaks of smooth muscle tissue as well as lymphatic hyperplasia at the margins.

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