0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Special Feature |

Radiological Case of the Month FREE

Arch Pediatr Adolesc Med. 1999;153(7):763-764. doi:.
Text Size: A A A
Published online

DENOUEMENT AND DISCUSSION: INTERMITTENT ILEOCOLIC INTUSSUSCEPTION CAUSED BY AN UNUSUAL CHORISTOMA

Figure 1. Computed tomographic scan showed a hyperdense mass occupying the cecum area.

Figure 2. Arrow points to target sign suggesting intussusception.

Figure 3. The cecal filling defect seen at enteroclysis.

Figure 4. Endoscopic view of polypoid cecal lesion that extends into the ascending colon.

Figure 5. Operative specimen showing resected ileal segment.

Figure 6. Opened specimen shows polypoid lesion with its long pedicule.

Figure 7. Gastric heterotopic mucosa and foci of pancreatic tissue.

At laparotomy an ileocecolic intussusception was reduced and the ileal segment containing a tumor was resected ( Figure 5). The lead point was a large pedunculated polyp (Figure 6). Histologic examination showed that the polyp consisted mainly of heterotopic gastric antral and fundic mucosa and foci of pancreatic tissue (Figure 7).

The term choristoma is applied to normal tissue in an abnormal location. Heterotopic gastric mucosa occurs anywhere in the gastrointestinal tract.1,2 Heterotopic gastric tissue in the small intestine is rare and in most cases is associated with a congenital anomaly.3 Use of imaging and endoscopic examination allows earlier diagnosis.4,5 A lead point is frequently present in chronic or intermittent intussusception and therefore nonoperative reduction is not indicated. Surgical resection of the involved segment is the preferred treatment, because it corrects the obstruction, avoids recurrence, and excludes the possibility of an associated malignant neoplasm.6,7

Accepted for publication March 18, 1998.

Corresponding author: Miguel Iuchtman, MD, Pediatric Surgery, Hillel Yaffe Medical Center, PO Box 169, Hadera 38100, Israel.

Lewin  KJRidell  RHWeinstein  WM Gastrointestinal Pathology and Its Clinical Implications.  New York, NY Igathe-Shoin1992;1171
Devereaux  CEDevereaux  RG Heterotopic gastric mucosa of the rectum with a review of the literature. J Clin Gastroenterol. 1994;1941- 45
Diamond  TRussell  CFJ Meckel's diverticulum in the adult. Br J Surg. 1985;72480- 482
Bhisitkul  DMUsternick  RShkolnic  A  et al.  Clinical application of ultrasonography in the diagnosis of intussusception. J Pediatr. 1992;121182- 186
Bar-Ziv  JSolomon  A Computed tomography in adult intussusception. Gastrointest Radiol. 1991;16264- 266
Azor  TBerger  DL Adult intussusception. Ann Surg. 1997;226134- 138
Lee  SMMosenthal  WTWeismann  RE Tumorous heterotopic gastric mucosa in the small intestine. Arch Surg. 1970;100619- 621

Tables

References

Lewin  KJRidell  RHWeinstein  WM Gastrointestinal Pathology and Its Clinical Implications.  New York, NY Igathe-Shoin1992;1171
Devereaux  CEDevereaux  RG Heterotopic gastric mucosa of the rectum with a review of the literature. J Clin Gastroenterol. 1994;1941- 45
Diamond  TRussell  CFJ Meckel's diverticulum in the adult. Br J Surg. 1985;72480- 482
Bhisitkul  DMUsternick  RShkolnic  A  et al.  Clinical application of ultrasonography in the diagnosis of intussusception. J Pediatr. 1992;121182- 186
Bar-Ziv  JSolomon  A Computed tomography in adult intussusception. Gastrointest Radiol. 1991;16264- 266
Azor  TBerger  DL Adult intussusception. Ann Surg. 1997;226134- 138
Lee  SMMosenthal  WTWeismann  RE Tumorous heterotopic gastric mucosa in the small intestine. Arch Surg. 1970;100619- 621

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 2

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics