Ectopic pancreas as a lead point for intussusception: case report and review of literature
Arturo Javier Cavazos Castro, Diana Altamirano Montealvo, Harold Castro Anaya, José Asz Sigall, Horacio G. CarvajalIntroduction:
Intussusception due to a pathological lead point is uncommon in children, usually occurring in cases with atypical presentation, recurrence, or failed nonoperative reduction. We report the case of a boy with intussusception due to a heterotopic pancreas.
Case presentation:
We report the case of a 3-year-old boy who presented with acute abdominal pain, vomiting, and bloody stools. Ultrasonography demonstrated findings consistent with intussusception. After unsuccessful pneumatic reduction under fluoroscopic guidance, we performed an exploratory laparotomy. Manual reduction revealed a 1 × 1 × 1 cm pathologic lead point in the ileum, requiring segmental bowel resection. Histopathologic examination confirmed subserosal ectopic pancreatic tissue.
Clinical discussion:
Heterotopic pancreas is rarely found in the ileum. When present in the distal bowel, it may rarely serve as a pathological lead point for intussusception.
Conclusion:
Ectopic pancreatic tissue is an extremely rare cause of a pathological lead point in pediatric intussusception. Clinicians should consider an underlying lesion in intussusception patients with atypical presentation, recurrence, or unsuccessful nonoperative reduction, as surgical management allows for both definitive treatment and histopathological diagnosis.