Combined ileal heterotopic pancreatic and gastric tissues causing ileocolic intussusception in an infant

Abstract

Pathological intussusception is rare in infancy with Meckel's diverticulum being the most common lesion. Isolated heterotopic pancreatic tissue in the serosa of the ileum causing intussusception is extremely rare. We report a case of ileal heterotopic pancreatic tissue associated with ectopic gastric mucosa causing ileocolic intussusception in an infant, with review of the literature.

Duodenal heterotopia in the distal ileum

“…The aetiology of GI heterotopias remains incompletely understood; they are believed to be congenital, arising either due to abnormalities during rotation of the foregut or due to metaplasia [1,2].…”

“…In cases where pancreatic and gastric heterotopias have been reported together, the clinical presentations result from a combination of these symptoms [1]. When heterotopic tissue causes intestinal inflammation or injury secondary to acid secretion, pancreatic enzyme activation and tissue digestion, patients present with symptoms like obstruction, intussusception and perforation [1,2].…”

“…Pancreatic heterotopia is mostly seen in the stomach, whereas combined (gastric and pancreatic) heterotopia is most commonly seen in the duodenum and jejunum. Involvement of other organs (esophagus, terminal ileum, Meckel's diverticulum, colon, gallbladder, spleen, mesentery, liver, bile ducts, omentum and urinary bladder) is rare but has been previously reported [1,2].…”

“…"Heterotopia" refers to the presence of a particular tissue type at a non-anatomical site, usually co-existing with original tissue in its correct anatomical location [1,2]. In other words, it implies the presence of histologically normal tissue, but at an abnormal site, in addition to presence of the original tissue at its original site.…”

Isolated ileal heterotopic pancreas in a child: A clinically undetected cause of ileoileal intussusception

“…Heterotopic pancreas in the ileum is a rare entity and when identified is usually associated with Meckel's diverticulum. Isolated heterotopic pancreas of the ileum (in absence of any other pathologic finding) is extremely rare and is usually an incidental finding during surgery [4,8,9,11]. Dolan et al have suggested that symptoms due to heterotopic pancreas are related to its size and mucosal relation [12].…”