Heterotopic Pancreas as a Cause of Intussusception and Gastrointestinal Bleeding: A Case Report
DOI:
https://doi.org/10.22516/25007440.1143Keywords:
Choristoma, pancreas, intussusception, gastrointestinal bleeding, laparoscopy, general surgery, case studyAbstract
Introduction: Intussusception is the telescoping of one segment of the intestine into an adjacent segment, leading to obstruction, inflammation, and ischemia. In adults, it accounts for 5% of intussusception cases, representing 1%–5% of intestinal obstructions. It is typically secondary to intraluminal lesions (benign or malignant) or iatrogenic factors.
Case Report: A 39-year-old male patient with a history of chronic gastritis presented with a three-month history of intermittent epigastric and left hypochondrial pain, which progressively increased in intensity and was associated with melena and rectal bleeding. On physical examination, he was hemodynamically stable, with mild tenderness in the left upper quadrant, no signs of peritoneal irritation, and positive findings for melena on digital rectal examination. Initial laboratory tests revealed no inflammatory response and normal hemoglobin levels. Upper gastrointestinal endoscopy and colonoscopy showed no abnormalities. Due to persistent abdominal pain, hepatobiliary ultrasound was performed, revealing a “target sign” suggestive of intussusception, which was confirmed with abdominal computed tomography. The patient underwent laparoscopic surgery, which identified an intestinal intussusception in the proximal ileum with a palpable intraluminal mass. Segmental resection and side-to-side anastomosis were performed. Histopathological analysis revealed a submucosal lipoma with ectopic pancreatic tissue.
Conclusion: Intestinal intussusception in adults is rare and even less frequently associated with ectopic pancreatic tissue.
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