Author Affiliations: Departments of Surgery (Drs Fan and Zhang) and Pathology (Dr Gan), Taizhou Hospital, Wenzhou Medical College, Zhejiang, China; and Department of Surgery, Rogaland Regional Hospital, University of Bergen, Stavanger, Norway (Dr Andr[[eacute]]n-Sandberg).
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
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The Rational Clinical Examination
Make the Diagnosis: Blunt Intra-abdominal Injury
The Rational Clinical Examination
Original Article: Does This Adult Patient Have a Blunt Intra-abdominal Injury?
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