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Jejunal small ectopic pancreas developing into jejunojejunal intussusception:A rare cause of ileus

World Journal of Gastroenterology 2009年第31期15卷 3954-3956页

作者： Shoji Hirasaki motoharu kubo Atsushi Inoue Yasuyuki Miyake Hisako Oshiro Division of Gastroenterology Kubo Hospital

Intussusception is rare in adults. We describe a 62-year-old man with jejunal ectopic pancreas that led to jejunojejunal intussusception and ileus. The patient was admitted to our hospital because of intermittent abdominal pain. Plain abdominal radiography showed some intestinal gas and fluid levels. Abdominal CT scan demonstrated a target sign suggesting bowel intussusception. Jejunography using a naso-jejunal tube showed an oval-shaped mass about 15 mm in diameter with a smooth surface in the jejunum, which suggested a submucosal tumor (SMT), and edematous mucosa around the mass. Partial jejunal resection was carried out and the resected oval-shaped tumor, 14 mm×11 mm in size, was found to be covered with normal jejunal mucosa. The tumor was histologically diagnosed as type ectopic pancreas according to the classification proposed by *** pain resolved *** case reminds us that jejunal ectopic pancreas should be included in the differential diagnosis of intussusception caused by an SMT in the intestine.

关键词： Jejunal submucosal tumor Small intestine Invagination Aberrant pancreas Surgery

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Pedunculated Brunner's gland hamartoma of the duodenum causing upper gastrointestinal hemorrhage

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World Journal of Gastroenterology 2009年第3期15卷 373-375页

作者： Shoji Hirasaki motoharu kubo Atsushi Inoue Yasuyuki Miyake Hisako Oshiro Department of Internal Medicine Kubo HospitalImabari 7992116Japan

A case of pedunculated Brunner＇s gland hamartoma （BGH） of the duodenum causing upper gastrointestinal （GI） hemorrhage is reported. The patient was a 47-year-old man who visited our hospital for further evaluation of tarry stools and shortness of breath. Endoscopic examination of the upper digestive tract revealed a large peduncular polyp with bleeding, about 30 mm in diameter, arising from the wall of the second portion of the duodenum. GI bleeding occurred from the base of the stalk of the polyp. Endoscopic polypectomy was performed. Histological examination of the specimen revealed that the main body of the polyp contained several Iobules of mature Brunner＇s gland with areas of cystic dilatation. The surface epithelium consisted of normal duodenal mucosa with areas of focal ulceration. This polyp was diagnosed as a BGH. The symptom of tarry stools resolved after endoscopic resection. Our case shows that treatment is necessary for duodenal BGH if GI bleeding occurs.

关键词： Brunner's gland Hyperplasia Duodenalpolyp Endoscopic polypectomy Gastrointestinal bleeding

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