Abstract
Objective Heterotopic pancreas (HP) is a condition in which there is well-differentiated pancreatic
tissue that lacks any anatomic or vascular contact with the pancreatic gland. It normally
arises from the stomach but can be found in other locations. Although it is usually
asymptomatic, obstructive symptoms, bleeding, or malignant degeneration can occur.
The incidence is very low, but it is significantly more common in patients with esophageal
atresia (EA). The aim of this study is to evaluate the incidence of HP in patients
with and without EA and to compare the results in both groups.
Material and Methods We conducted a 2-year prospective study in pediatric patients who benefited from
an upper gastrointestinal endoscopy. Patients were divided into two groups: group
“A” comprised patients with EA and group “B” those without EA. The variables analyzed
were the clinical presentation, presence of HP, location, associated malformations,
genetic disorders, and management.
Results A total of 192 consecutive patients were included in the study: 51 (26.6%) in group
A and 141 (73.4%) in group B. Indications for endoscopy in group B were eosinophilic
esophagitis in 37 (19.2%) patients, celiac disease in 23 (11.95%) patients, and other
disorders in 81 (42.2%) patients. Gastric HP was found in seven patients, all of them
in group A. All lesions were hosted in the prepyloric antrum. The prevalence of HP
in groups A and B was 13.7 and 0%, respectively (p < 0.05). Female gender was predominant in patients with AE and HP, this result being
statistically significant (p = 0.044). No other associated malformation or genetic syndrome studied showed association
with HP. Only one patient debuted with upper gastrointestinal (GI) bleeding and required
excision, while six patients were asymptomatic. The mean follow-up was 54 months (range:
45–78 months).
Conclusion The incidence of gastric HP is more common in patients with EA, with the female gender
being a risk factor for their association. Active search and follow-up is recommended
as it may become symptomatic anytime and need resection.
Keywords
ectopic pancreas - heterotopic pancreas - esophageal atresia - gastrointestinal bleeding
