Clinical and Experimental Gastroenterology (Apr 2024)
Jejunal Ectopic Pancreatic Tissue Rest as Lead Point in Patients with Intussusception: A Rare Case Report and Review of Literature
Abstract
Worku Mekonnen Sefefe,1 Destaw Biadgie Tesfaw,2 Andualem Dagne Tebikew,2 Assefa Sisay Ayenew,3 Bereket Amare Dencha,4 Temesgen Agegnehu Abebe1 1Department of Surgery, Debre Markos University (DMU), Debre Markos, Amhara, Ethiopia; 2Department of Surgery, Bahir Dar University, Bahir dar, Amhara, Ethiopia; 3Department of Surgery, Akesta General Hospital, Wollo, Amhara, Ethiopia; 4Department of Pathology, Bahir Dar University, Bahir dar, Amhara, EthiopiaCorrespondence: Worku Mekonnen Sefefe, Department of Surgery, Debre Markos University (DMU), Debre Markos, Amhara, Ethiopia, Tel +251912101424, Email [email protected]: Ectopic pancreas (EP), characterized by pancreatic tissue outside its usual location, poses diagnostic challenges due to its asymptomatic nature in most cases. Gastric lesions are often symptomatic, causing epigastric pain or gastric outlet obstruction. Rarely, jejunal lesions can lead to intestinal obstruction or intussusception. The elusive preoperative diagnosis lacks specific biochemical markers, relying on intraoperative biopsy and histopathology as gold standards.Case Presentation: We present a unique case of a 37-year-old female with 12-hour crampy abdominal pain, bilious vomiting, blood-mixed diarrhea, abdominal distension, and obstructive symptoms. Imaging revealed jejunojejunal intussusception with a jejunal mass as the lead point. Intraoperatively, also identified jejunal mass as lead point. Resection of mass and end-to-end jejunojejunal anastomosis were performed, resulting in a successful outcome. Histopathological examination identified a type I ectopic pancreas within the muscularis propria. Twelve months postoperatively, the patient exhibited no stricture or recurrence.Conclusion: Ectopic pancreas, with varied symptoms, poses diagnostic hurdles. Despite the diagnostic challenges, surgical excision remains the optimal treatment for symptomatic cases. This report contributes to the limited literature on ectopic pancreas, emphasizing the importance of considering this entity in the differential diagnosis of gastrointestinal pathology.Keywords: ectopic pancreas, pancreatic heterotopia, jejunojejunal intussusception, lead point, Ethiopia
