99mTc-Pertechnetate Scintigraphy Capturing Heterotopic Gastric Mucosa, Intestinal Duplication, and Heterotopic Pancreas in Imaging—A Rare Encounter

A 15-year-old adolescent boy was hospitalized because of abdominal pain. Blood tests indicated inflammation markers were elevated. Fecal occult blood test was weakly positive. CT revealed thickening and edema of the small bowel wall, accompanied by gas density shadows and blurring of fat interstitial spaces. Thus, intestinal perforation and gastrointestinal hemorrhage were suspected. In order to investigate the underlying cause, 99m Tc-pertechnetate scintigraphy was performed. A tracer accumulated lesion was presented around the navel, suggestive of heterotopic gastric mucosa. Surprisingly, postoperative pathology confirmed coexistence of heterotopic gastric mucosa, intestinal duplication, and heterotopic pancreas, which was a rare condition.