Recurrent Intussusception in 2-Month-Old Boy Caused by Submucosal Cyst of Heterotopic Gastric Mucosa

Abstract

A 2-month-old boy presented with a pale face and suffered from abdominal pain intermittently. He was suspected of having intussusception and was subjected to closed reduction. The following day, he started to drink his mother’s milk, but he experienced recurrent intussusception twice, i.e., on the second and third days of hospitalization. The third intussusception was difficult to reduce; he underwent abdominal ultrasonographic examination, and an ileac polyp and an ileo-ileal intussusception were found. He was scheduled for surgery, but he experienced recurrent intussusception twice during the waiting period. Emergency laparotomy was performed on the fourth day of hospitalization. The ileo-ileo-colon intussusception was reduced by Hutchinson’s method. During laparotomy, a polyploid tumor measuring 2.0 × 2.0 cm was found on the antimesenteric border of the ileum, about 25 cm from the ileocecal valve. The tumor was subjected to wedge resection, and the ileum was sutured. Because microscopic examination revealed gastric mucosa in the submucosal polyp, he was diagnosed as having heterotopic gastric mucosa. The intussusception caused by the heterotopic gastric mucosa in the ileum develops regardless of age and the frequency of recurrence. The ectopic gastric mucosa of the submucosal cyst is rare and difficult to distinguish from duplication. It is a risk factor for intussusception and surgical resection is necessary.