Pancreatic Heterotopia Presenting as Ileal Intussusception in an Adult: A Case Report and Literature Review

Abstract

Pancreatic heterotopia is a rare congenital disorder characterized by ectopic pancreatic tissue without anatomical or vascular connection to the native pancreas. It is mostly asymptomatic and can present with non-specific gastrointestinal symptoms. Rare complications such as intussusception have been reported with this condition. We report the case of a 38-year-old female with a history of intermittent abdominal pain that was initially labeled and managed as irritable bowel syndrome. Advanced imaging revealed small intestinal intussusception, which turned out to be secondary to pancreatic heterotopia. The diagnosis was confirmed postoperatively through histopathological examination. Recent studies indicate that while the incidence of pancreatic heterotopia is relatively low, it is frequently identified as an incidental finding during abdominal surgeries, with intussusception reported in rare cases as a lead point for obstruction. Imaging modalities such as contrast-enhanced CT and MRI are pivotal for diagnosis, although laparotomy often remains essential for definitive management. This case highlights the diagnostic challenges and underscores the importance of advanced imaging techniques and multidisciplinary management in resolving atypical abdominal presentations.

Keywords: acute abdomen; ectopic pancreas; ileo-ileal intussusception; pancreatic heterotopia; small intestinal obstruction; small-bowel intussusception; unexplained abdominal pain.

Figure 1. (A) MRI abdomen after contrast showing enhancing polypoidal mass at the terminal ileum (red arrow). (B) Coronal T2 MRI showing dilated terminal ileum and the polyp (red arrow)

Figure 2. Coronal CT abdomen after contrast showing intussusception with a lead point (red arrow)