scholarly journals Single-site laparoscopic treatment of pathological intussusception secondary to heterotopic pancreas in an 11-month old infant

2021 ◽  
Author(s):  
Yulei Jing ◽  
Dafeng Wang ◽  
Xiaomin Zhu ◽  
Yijin Cai ◽  
Xia li ◽  
...  
Keyword(s):  
Early Recurrence ◽  
Pancreatic Tissue ◽  
Heterotopic Pancreas ◽  
Single Site ◽  
Attractive Alternative ◽  
Lead Point ◽  
Case Presentation ◽  
Pathological Lead Point ◽  
Well Differentiated ◽  
Recurrent Intussusception

Abstract Background: Intussusception in children is mostly idiopathic, while intestinal intussusception in infancy is uncommon. Specially, intussusception caused by isolated ileal heterotopic pancreas, the abnormal localization of a well-differentiated pancreatic tissue in the ileal serosa, is relatively rare. Early recurrence of intussusception would suggest the presence of pathological lead point and the possibility of surgical exploration. Case presentation: An 11-month-old boy, diagnosed with recurrent intussusception caused by ileal heterotopic pancreas, was admitted to our hospital. After admission, the baby was resuscitated with normal saline and received air edema twice, but both failed. Given the presence of pathological intussusception, the boy was sent to operating theater and received a single-site laparoscopically assisted surgery. The patient recovered successfully and got a satisfactory cosmetic result.Conclusions: Due to its minimally invasive and diagnostic advantages, laparoscopy proves to be a safe and attractive alternative, especially for emergency patient with stable hemodynamics but no definite radiological diagnosis. Meanwhile, we emphasize the importance of paying essential attention to the condition that recurrent intussusception of extreme age should always be taken into consideration.

scholarly journals Two simultaneous intussusceptions in a neonate with DiGeorge syndrome: A case report

2021 ◽  
Vol 10 ◽  
pp. 9
Author(s):  
Uday Bhaskar MNS Mokrala ◽  
Lakshmi Sundararajan ◽  
Chandra Kumar Natarajan
Keyword(s):  
Small Bowel ◽  
Pulmonary Stenosis ◽  
Emergency Laparotomy ◽  
Lead Point ◽  
Case Presentation ◽  
Entire Small Bowel ◽  
Small Bowel Intussusception ◽  
Pathological Lead Point ◽  
Male Neonate ◽  
Resection And Anastomosis

Background: Double simultaneous intussusception is a peculiar and rare variety of intussusception with only 3 previously reported neonatal cases. Case presentation: A 15-day-old male neonate with respiratory distress was found to have Tetralogy of Fallot and hypoplastic pulmonary stenosis. Small bowel intussusception was diagnosed on ultrasound abdomen following hematochezia on the next day. Emergency laparotomy revealed two intussusceptions, ileocolic and jejunojejunal, with bowel gangrenous requiring resection and anastomosis. No pathological lead point was identified. He recovered with supportive care and was discharged. Conclusion: Simultaneously occurring double intussusceptions are extremely rare in neonates, and thorough examination of the entire small bowel in cases of intussusception is key to the diagnosis.

scholarly journals Heterotopic pancreas in the gastrointestinal tract in children: a single-center experience and a review of the literature

2019 ◽  
Vol 45 (1) ◽  
Author(s):  
Giorgio Persano ◽  
Noemi Cantone ◽  
Elisa Pani ◽  
Enrico Ciardini ◽  
Bruno Noccioli
Keyword(s):  
Elective Surgery ◽  
Incidental Finding ◽  
Gastrointestinal Symptoms ◽  
Pancreatic Tissue ◽  
Heterotopic Pancreas ◽  
Single Institution ◽  
Clinical Notes ◽  
Single Center Experience ◽  
Heterotopic Tissue ◽  
Well Differentiated

Abstract Background Heterotopic pancreas, that is the abnormal localization of a well-differentiated pancreatic tissue, is a rare occurrence in pediatric patients. Most lesions are found incidentally; in some circumstances, the presence of heterotopic pancreas may cause gastrointestinal symptoms, such as obstructive symptoms or bleeding. Patients and methods The clinical notes of patients with histological diagnosis of heterotopic pancreas treated at Meyer Children’s Hospital between 2009 and 2017 have been retrospectively examined. Four variables have been examined: clinical presentation, age at diagnosis, timing of surgery and localization of the heterotopic pancreas. Patients have been classified accordingly. Results Fourteen patients were diagnosed with heterotopic pancreas at a single institution. In half cases, heterotopic pancreas caused symptoms that warranted surgical exploration. Symptomatic patients were significantly older than patients in whom heterotopic pancreas was an incidental finding (mean age 9 years and 5 months vs 2 years and 9 months; p = 0.02). Heterotopic pancreas was more frequently found in patients who underwent urgent surgical procedure than in patients who underwent elective surgery (2.61% vs 0.22%; p < 0.0001). In all cases, foci of heterotopic pancreas were resected. Conclusion Heterotopic pancreas is usually discovered in the submucosa of the stomach, duodenum and small bowel. Heterotopic tissue may cause symptoms related to mechanical complications, bleeding from the surrounding intestinal mucosa or, occasionally, to the development of malignancy. Heterotopic tissue is a rare but clinically relevant cause of gastrointestinal symptoms. The presence of heterotopic tissue should be considered in children with gastrointestinal symptoms of unclear origin and surgical resection is advisable.

scholarly journals Heterotopic Pancreas in the Gallbladder: Case Report and Literature Review

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Emad Aborajooh ◽  
Ibrahim Khalil Khairi Ghayada ◽  
Yasser Mustafa Issa Lafi
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Literature Review ◽  
Acute Cholecystitis ◽  
Gallbladder Wall ◽  
Pancreatic Tissue ◽  
Heterotopic Pancreas ◽  
Abdominal Ultrasonography ◽  
Pancreatic Acini ◽  
Case Presentation ◽  
Upper Abdominal

Introduction. Heterotopic pancreas (HP) is the congenital presence of pancreatic tissue outside its normal location in the absence of vascular and anatomical connection with the main pancreas. HP can affect any part of the gastrointestinal tract, and it is mostly encountered in the stomach. The gallbladder is a rare site of HP, and our literature review revealed that only 38 cases were reported. We present a case of HP in the gallbladder that was presented with a picture of acute cholecystitis. After the case presentation, we will discuss HP in the gallbladder by reviewing the literature. Case Presentation. A 49-year-old male presented to the emergency department complaining of progressively worsening right upper abdominal pain for the last 24 hours. After thorough history and physical examination, a provisional diagnosis of acute cholecystitis was made. Abdominal ultrasonography revealed a rim of edema surrounding the gallbladder wall with two stones impacted at the gallbladder neck. Laparoscopic cholecystectomy was performed with an uneventful postoperative course, and the patient was discharged the next day. Microscopic examination of the gallbladder showed that a heterotopic pancreatic tissue, composed of a large number of pancreatic acini and few ducts with the absence of islets of Langerhans, was found around the cystic duct. The patient was asymptomatic at the regular follow-up six months postoperatively. Conclusion. HP in the gallbladder is an extremely rare finding. Its clinical presentation is not different from other cholecystopathic diseases. Most cases were accompanied by cholelithiasis. Preoperative laboratory and imaging modalities are usually not helpful in the diagnosis of HP in the gallbladder. The definitive diagnosis is made by histological examination of the gallbladder specimen. Laparoscopic cholecystectomy is sufficing treatment.

Heterotopic Pancreas as Lead Point in Intussusception: New Variant of Vitellointestinal Tract Malformation

1999 ◽  
Vol 2 (4) ◽  
pp. 367-370 ◽  
Author(s):  
Robin Abel ◽  
Charles E. Keen ◽  
John B. Bingham ◽  
John Maynard ◽  
Meena R. Agrawal ◽  
...  
Keyword(s):  
Small Intestine ◽  
Meckel’S Diverticulum ◽  
Pancreatic Tissue ◽  
Heterotopic Pancreas ◽  
Meckel's Diverticulum ◽  
Ectopic Gastric Mucosa ◽  
Lead Point ◽  
Heterotopic Pancreatic Tissue ◽  
New Variant ◽  
Acinar Tissue

Two cases of intussusception are reported with heterotopic pancreatic tissue attached to and draining into the ileum. The first patient, a boy aged 16 months, presented with ileoileal intussusception. The diagnosis was confirmed on ultrasound scan. Laparotomy and resection were performed. A 12-mm nodule of heterotopic pancreatic tissue was identified in the ileal serosa at the apex of the intussusceptum, fully formed with acinar tissue, islets, and draining duct. The second patient, also a boy aged 16 months, presented with obstructed ileocolic intussusception in which the lead point at surgery resembled a Meckel's diverticulum. Histopathology revealed a similar 10-mm nodule of fully formed pancreatic tissue in the ileal serosal tissues, with some acinar tissue extending through the wall of the intestine alongside ductal structures. In both cases there was ectopic gastric mucosa either in the distal part of the draining duct or in the small intestine itself at the opening. Heterotopic pancreas is a rare cause of intussusception. We propose that this lesion is of vitellointestinal tract origin, conceptually similar to a Meckel's diverticulum but without a diverticulum as such. Heterotopic pancreatic tissue occurring alone is more common in the proximal small intestine, duodenum, and stomach than in the ileum, and it is often asymptomatic.

scholarly journals Neonatal intussusception secondary to intestinal duplication cyst: A case report

2021 ◽  
Vol 10 ◽  
pp. 48
Author(s):  
Haseen Fathima ◽  
Divya Mishra ◽  
Nishanth Rajan ◽  
Joseph Manuel ◽  
Manjiri Dilip Phansalkar ◽  
...  
Keyword(s):  
Case Report ◽  
Histopathological Examination ◽  
Duplication Cyst ◽  
Lead Point ◽  
Case Presentation ◽  
Intestinal Duplication ◽  
Bleeding Per Rectum ◽  
Pathological Lead Point ◽  
High Index Of Suspicion ◽  
Complications And Mortality

Background: Intussusception is a rare cause of bleeding per rectum in neonates. Duplication cyst as a pathological lead point for intussusception is rarer too. Case Presentation: A female neonate presented with bilious vomiting and bleeding per rectum. Ultrasonography diagnosed it as intussusception. Intraoperatively, on reduction of intussusception, a mass was found which on histopathological examination (HPE) revealed a duplication cyst. Conclusion: A high index of suspicion is required for an early diagnosis of neonatal intussusception, which is essential for preventing complications and mortality.

scholarly journals Intussusception in a premature newborn: A case report

2021 ◽  
Vol 10 ◽  
pp. 30
Author(s):  
Daniel Acosta Farina ◽  
Diego León-Ochoa ◽  
Karen Serrano-Concha ◽  
Manuel Cabrera-Viteri ◽  
Jorge Oliveros-Rivero ◽  
...  
Keyword(s):  
Case Report ◽  
Intestinal Obstruction ◽  
Clinical Picture ◽  
Neonatal Period ◽  
Lead Point ◽  
Case Presentation ◽  
Premature Newborn ◽  
Premature Babies ◽  
Neonatal Intestinal Obstruction ◽  
Pathological Lead Point

Background: Intussusception is rare in the neonatal period and even less common in premature babies. Case Presentation: We present a case of a premature newborn with an insidious clinical picture characterized by irritability and multiple vomits. Ultrasound was diagnostic of intussusception. The baby had a jejunal intussusception without any pathological lead point, with a favorable outcome. Conclusion: Intussusception is a rare cause of neonatal intestinal obstruction especially in premature neonates.

scholarly journals Risk factors for recurrent intussusception in children: a retrospective cohort study

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018604 ◽  
Author(s):  
Wan-liang Guo ◽  
Zhang-chun Hu ◽  
Ya-lan Tan ◽  
Mao Sheng ◽  
Jian Wang
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Lead Point ◽  
Duration Of Symptoms ◽  
Factors Associated ◽  
Pathological Lead Point ◽  
Recurrent Intussusception ◽  
Left Abdomen

ObjectiveThe aim of this study was to assess the frequency of clinical features and pathological lead points in recurrent intussusception, with a special focus on the risk factors that lead to recurrent intussusception.DesignThis is a retrospective cohort study. A 5-year retrospective study was performed between January 2012 and July 2016 in the Children’s Hospital of Soochow University, Suzhou, China, to determine the clinical features and pathological lead points of recurrent intussusception.SettingThis is a retrospective chart review of recurrent intussusception cases in a large university teaching hospital.ParticipantsThe medical records were obtained for 1007 cases with intussusception, including demographics, clinical signs and symptoms, imaging and recurrence times if available.InterventionsUnivariate and multivariate logistic regression analyses were used to measure significant factors affecting recurrent intussusception and recurrent intussusception with pathological lead points.ResultsThere were 481 total episodes of recurrence in 191 patients. Among these, 87 had one recurrence and 104 had multiple recurrences. After comparing recurrent and non-recurrent intussusception cases using univariate analysis, it was determined that the factors associated with recurrent intussusception were age (>1 year), duration of symptoms (≤12 hours), the lack of bloody stool, paroxysmal crying or vomiting, the mass location (right abdomen) and pathological lead point (P<0.05). Age (>1 year), duration of symptoms (≤12 hours), the absence of vomiting, mass location (right abdomen) and pathological lead point were significantly independently predictive of recurrent intussusception. The factors associated with recurrent intussusception with lead points present were vomiting and mass location in the right abdomen (P<0.05). Vomiting and mass location (left abdomen) were significantly predictive of recurrent intussusception with lead points.ConclusionsAge (>1 year), symptom duration (≤12 hours), the absence of vomiting, mass location (right abdomen) and pathological lead points were significantly predictive of recurrent intussusception. Vomiting and mass location (left abdomen) were significantly predictive of recurrent intussusception with lead points.

EP.FRI.543 A rare case of acute jejuno-jenual intussusception in a patient with Roux-en-Y bypass secondary to a benign polyp

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Armin Fardanesh ◽  
Jamie Powell ◽  
Maitham Al-Whouhayb
Keyword(s):  
Small Bowel ◽  
Rare Case ◽  
Exploratory Laparotomy ◽  
Lead Point ◽  
Benign Polyp ◽  
Small Bowel Intussusception ◽  
Pathological Lead Point ◽  
Malignant Lesions ◽  
Ectopic Pacemaker ◽  
Upper Abdominal

Abstract Introduction Roux-en-Y Gastric bypass (REYGB) amounts for a third of surgical bariatric interventions. Small bowel obstruction (SBO) is a long-term complication in REYGB and can be caused by intussusception of bowel, in approximately 0.5% of procedures.  Intussusception in REYBG is mostly attributed to dysmotility. This report demonstrates a rare case of intussusception in REYGB secondary to a benign polyp.  Case description A 45 year old female, three years post REYGB, presented to A&E with acute, extreme upper abdominal pain, with three days absolute constipation. She was tender on examination with normal blood tests. CT scan demonstrated small bowel intussusception. Initial concerns were of intussusception of the jejuno-jejunostomy anastomosis causing SBO.  She had an exploratory laparotomy, which confirmed intussusception, however this was 20cm distal to the jejuno-jejunostomy. Bowel was gently reduced, and deemed viable. On thorough run-through, a small segment at the transition point, was considered abnormal on palpation. This region was resected and a 1x1cm intraluminal polyp was identified as the causative lead point. The patient did well postoperatively.  Discussion Small bowel intussusception in adults is typically attributed to pathological lead point, such as benign or malignant lesions. Intussusception in REYBG is a rare but well-documented cause of intestinal obstruction, usually attributed to dysmotility, secondary to ectopic pacemaker cells particularly around anastomoses. In this case, the intussusception was caused by an unusual pathology separate from the jejuno-jejunal anastomosis. We recommend thorough examination of all adjacent bowel to exclude lesions, in this case a polyp, which could result in recurrence. 

scholarly journals Adenomyoma of the small intestine a rare pathological lead point for intussusception in an infant

SpringerPlus ◽  
2014 ◽  
Vol 3 (1) ◽  
pp. 616 ◽  
Author(s):  
You-Jung Bak ◽  
Udo Rolle ◽  
Stefan Gfroerer ◽  
Henning C Fiegel
Keyword(s):  
Small Intestine ◽  
Lead Point ◽  
Pathological Lead Point
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