Endoscopy 2010; 42: E121
DOI: 10.1055/s-0029-1243988
Unusual cases and technical notes

© Georg Thieme Verlag KG Stuttgart · New York

Heterotopic pancreas: a difficult diagnosis

G.  Payeras1 , C.  Castellón2 , J.  De Jaime2 , R.  Barranco1 , A.  Calvache1 , P.  Castro1
  • 1Digestive Endoscopy Unit, Department of Gastroenterology, Hospital Infanta Elena, Madrid, Spain
  • 2Department of Surgery, Hospital Infanta Elena, Madrid, Spain
Further Information

G. Payeras, MD 

Digestive Endoscopy Unit
Department of Gastroenterology
Sanatorio San Fco. Asis

Joaquin Costa 28 Madrid
Madrid 28002
Spain

Fax: +34-91-4113839

Email: gpayeras@yahoo.es

Publication History

Publication Date:
19 March 2010 (online)

Table of Contents

A 45-year-old man was admitted to our hospital complaining of epigastric pain and nausea for 2 days. He had no history of systemic disease. Laboratory tests at admission, including amylase, were normal except for a 12 100/mm3 leucocyte count (89 % polymorphonuclear). Abdominal ultrasonography revealed an irregular, hypoechoic solid lesion of 37 × 28 mm, and computed tomography scan showed a 37-mm, thick-walled, extraluminal cystic lesion.

Gastroscopy revealed a submucosal lesion at the antrum of the stomach with a necrotic eschar on its surface ([Fig. 1]; [Video 1]). Endoscopic ultrasonography showed a heterogeneous lesion suggesting muscular layer necrosis. The patient was successfully treated surgically by subtotal gastrectomy. Pathological examinations confirmed a diagnosis of aberrant pancreas ([Fig. 2]).

Zoom Image

Fig. 1 Gastroscopy revealed a submucosal lesion at the antrum of the stomach.


Quality:

Video 1 Gastroscopy revealed a submucosal lesion at the antrum of the stomach with a necrotic eschar on its surface.

Zoom Image

Fig. 2 Pathological examination confirmed a diagnosis of aberrant pancreas.

Heterotopic pancreas is the presence of pancreatic tissue lying outside of its normal location and lacking anatomic or vascular connections with the pancreas [1]. It is located in the antrum in 85 % – 95 % of cases, and it is usually asymptomatic but may become clinically evident depending on the size, location, and the pathological changes [2]. In some cases, because the findings on imaging studies are not specific for aberrant pancreas, its preoperative definitive diagnosis is difficult [3]. The definitive diagnosis of aberrant pancreas is attained on histopathological examination and it should always be considered in the differential diagnosis of gastric masses.

Competing interests: None

Endoscopy_UCTN_Code_CCL_1AB_2AC_3AB

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References

G. Payeras, MD 

Digestive Endoscopy Unit
Department of Gastroenterology
Sanatorio San Fco. Asis

Joaquin Costa 28 Madrid
Madrid 28002
Spain

Fax: +34-91-4113839

Email: gpayeras@yahoo.es

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References

G. Payeras, MD 

Digestive Endoscopy Unit
Department of Gastroenterology
Sanatorio San Fco. Asis

Joaquin Costa 28 Madrid
Madrid 28002
Spain

Fax: +34-91-4113839

Email: gpayeras@yahoo.es

Zoom Image

Fig. 1 Gastroscopy revealed a submucosal lesion at the antrum of the stomach.

Zoom Image

Fig. 2 Pathological examination confirmed a diagnosis of aberrant pancreas.