Complete heterotopic pancreas

A 43-year-old man presented to our hospital with acute abdominal pain and decreased bowel movements. Physical examination revealed a painful abdominal mass in mesogastrium. A small intestine contrast ultrasonography showed an ileal–ileal intussusception looked like a doughnut shape, with the telescoped part inside (“double cockade”, “bowel in the bowel”), created by the hyperechoic central core and mesentery surrounded by the hypoechoic outer oedematous bowel (Fig. 1, panel a), confirmed by MR-enterography (Fig. 1, panel b). Laparoscopy was performed and showed an intussusception of 10 cm length at about 80 cm from ileo-ciecal valve. A side-to-side anastomosis at ileal level was performed. Pathological examination revealed a polyp with a short peduncle (Fig. 2, panel a) diagnosed as complete heterotopic pancreas with both ductal–acinar and insular features. Antibodies to glucagon were used to identify alpha cells (Fig. 2, panel b). Postoperative course was uneventful.