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A 62-year-old man was admitted to the emergency department for abdominal trauma. His clinical record showed no previous abdominal symptoms such as pain, nausea, or vomiting. An emergency abdominal laparotomy was performed on the patient under general anesthesia. During completion of the surgery, a yellowish gray, rubbery 2.0 × 1.5 × 1.0-cm mass with a clear border was accidentally found on the antimesenteric side of the ileum, 30 cm from the ileocecal valve. A 5-cm segment of the ileum, containing the mass, was removed, and an end-to-end anastomosis was performed. The remainder of the bowel was grossly unremarkable, and the mass was submitted for light microscopic examination (Figure 1 and Figure 2).
The lesion, situated within the submucosa of the ileum, shows evidence of pancreatic ducts and acinar cells. Ileum mucosa is visible at the lower right (hematoxylin-eosin, ×100).
Histological specimen of the lesion, which is composed of pancreatic ducts, acinar cells, and islets of Langerhans (hematoxylin-eosin, ×100).
B. Adenomatous polyp
C. Meckel diverticulum
D. Pancreatic heterotopia
Fan B, Zhang F, Gan M, Andrén-Sandberg Å. Image of the Month—Quiz Case. Arch Surg. 2005;140(9):911. doi:10.1001/archsurg.140.9.911