Jejunal Ectopic Pancreatic Tissue Rest as Lead Point in Patients with Intussusception: A Rare Case Report and Review of Literature

Abstract

Background

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

Ethical and Consent Statements

Institutional approval letter from Bahir Dar Comprehensive Specialized Hospital for publishing this case report is provided.

Written informed consent for the case report was taken from the patient to obtain images and other clinical information to be reported in the journal for publication. The patient understands that her name and initial will not be published and due efforts will be made to conceal her identity. Our institution also witnessed that the consent taken from the patient.

Disclosure

The authors report that no known competing financial interests or personal relationships that could have influenced the work reported in this study.