A Case of Intussusception Caused by Small Intestinal Adenomyoma Associated With Ectopic Pancreas in a 1-Month-Old Infant

Abstract

The patient was a 1-month-old boy with no medical history. Owing to the onset with vomiting, he was diagnosed as having intussusception, which was resolved by high-pressure enema. However, a small intestinal intussusception appeared again the following day, and he was transferred to our hospital. We performed high-pressure enema again, but it failed to relieve the ileal intussusception. Emergency laparotomy with umbilical Ω incision was performed, and we found intussusception in the ileum. We repaired it by the Hutchinson method and found a tumor in the ileum wall. We partially resected the ileum, including the tumor, and performed end-to-end anastomosis. Adenomyoma (heterotopic pancreas, Heinrich Type 2) was diagnosed by histopathological examination. The postoperative course was uneventful; the patient was discharged nine days after surgery, and no recurrence was observed. Adenomyoma is a very rare tumor that often develops in intussusception in children and is often difficult to diagnose by imaging. Therefore, early surgery may be considered for patients with atypical presentations such as recurrence, difficulty in repair, or other cases outside the preferred age group, without adhering to non-surgical treatment.