[Ileo-ileal intussusception over an islet of heterotopic gastric mucosa without Meckel's diverticulum]

Three laparotomies have been necessary to find the origin of intermittent episodes of abdominal pain for eleven years in a girl: appendectomy at the age of three, surgical exploration at nine, and emergency laparotomy at fourteen for acute intestinal obstruction: ileo-ileal, secondary iléo-colic intussusception, reduction and ileal resection discovering an 2 x 2 cm area of normal fundic gastric mucosa. Heterotopic gastric mucosa in the small bowel is a rare congenital anomaly (12 pediatric and 5 adult cases previously reported in the literature). These folds of gastric mucosa are located more often in the terminal ileum than in the jejunum and act as the leading part of intussusception: the clinical finding were usually those of subacute obstruction of the small intestine and can occur during several years before an intestinal obstruction leading to surgery: after reduction of the intussusception, intestinal resection must be done. Intestinal ulcerations due to peptic secretion of the ectopic gastric mucosa with intestinal bleeding and anemia or perforation are less frequent.