ABSTRACT
Adult intussusception is a relatively rare clinical entity. Almost 90% of cases of intussusception in adults are secondary to a pathologic condition that serves as a lead point. Lymphangioma of the small bowel is an unusual tumour that has been rarely reported to cause intussusception. In this paper, we present a rare case of adult intussusception due to jejunal lymphangioma. A 22-year-old female patient with a medical history significant for anaemia presented with intermittent colicky abdominal pain, diarrhoea and oedema of the inferior limbs for the past three months. Ultrasonography and CT scan revealed a typical target sign with dilated intestinal loops. At laparotomy, a jejuno-jejunal intussusception was found. Partial resection of the jejunum was performed. Macroscopic examination of the surgical specimen revealed a pedunculated polyp measuring 2 cm in diameter. Histological sections of the polyp revealed in the lamina propria and submucosal layer of the jejunum several markedly dilated thin-walled lymphatic spaces lined with single layers of flat endothelial cells. The final pathologic diagnosis was submucosal lymphangioma. This case report indicates that intussusception, although rare in adults, should be considered in the differential diagnosis of abdominal pain. Moreover, it should be taken into consideration that lymphangioma is one of the possible lesions that can cause intussusception.
Subject(s)
Intestinal Polyps/complications , Intussusception/etiology , Jejunal Neoplasms/complications , Lymphangioma/complications , Biopsy , Diagnosis, Differential , Female , Humans , Intestinal Polyps/diagnosis , Intestinal Polyps/surgery , Intussusception/diagnosis , Intussusception/surgery , Jejunal Neoplasms/diagnosis , Jejunal Neoplasms/surgery , Lymphangioma/diagnosis , Lymphangioma/surgery , Predictive Value of Tests , Tomography, X-Ray Computed , Treatment Outcome , Young AdultABSTRACT
The presence of heterotopic pancreas is unusual with an estimated incidence of 0.2% of upper abdominal operations. Heterotopic pancreas occurs predominantly in the stomach, duodenum and proximal jejunum. Isolated pancreatic heterotopia of the ileum is very rare and is usually found in a Meckel's diverticulum. In most cases, these heterotopias are asymptomatic and are only incidentally detected upon pathological examination or autopsy. In this paper, the authors report two cases of pancreatic heterotopia involving, respectively, the duodenum and ileum that were fortuitously discovered on a surgical specimen and during laparotomy for unrelated causes.