Abstract
A 9-year-old boy was referred to our institute due to vomiting and recurrent attacks of abdominal pain. Ultrasonographic examination showed intussusceptions. A contrast enema reduction revealed ileocecal intussusceptions; however, pathological lesion could not be detected. Intussusception recurred 4 times. At the third episode of intussusception, a contrast enema reduction revealed ileoileocecal intussusceptions; however, we could not detect a pathological leading lesion. Therefore, after the fourth contrast enema reduction, computed tomography examination with filing contrast material in the intestine was performed, and a shadow defect was revealed at the distal ileum. Laparoscopy assisted surgery was then performed. During the operation, a tumor mass palpable at the ileum, existed 50 cm above the ileocecal valve, and the mass was resected. Microscopic examination revealed a heterotopic gastric mucosa. Although no diverticular projection was observed in this case, vitello-intestinal remnant was strongly indicated because there was an attached mesodiverticular artery. We must keep in mind that the heterotopic gastric mucosa without Meckel's diverticulm may be a cause of intussusception, although it is rare. Furthermore, careful inspection and palpation are necessary to detect the lesion during operation.
