Aberrant pancreas in the gallbladder wall

Abstract

We present three cases of heterotopic pancreas in the gallbladder wall. The patients (all female) presented with abdominal pain. Ultrasonography revealed polypoid tumor with coexistence of lithiasis in two cases. All patients underwent cholecystectomy. Microscopy revealed chronic cholecystitis and cholesteatosis and heterotopic pancreatic tissue. Heterotopic pancreas in the gallbladder wall is a rare heterotopia, with 23 cases reported in the international literature.

Pancreatic heterotopia in the gallbladder: an incidental finding after cholecystectomy

“…In contrary to other reports which stated that pancreatic tissue in the gallbladder was more common in women and asymptomatic [9,10], our patient was male and had symptoms of acute pancreatitis. We agree with other authors that it is impossible to diagnose pancreatic heterotopia in the gallbladder before and during operation and only very detailed postoperative histological examination can detect pancreatic tissue.…”

“…So far, neither ultrasound nor CT and magnetic resonance imaging can confirm the diagnosis of ectopic pancreas preoperatively [1,9,10]. Differential diagnosis based on the presence of gallstones, cholesterol polyps, adenomyoma, carcinoma, cholecystitis, cysts, abscess formation and other lesions is almost impossible [9].…”

Ectopic pancreatic tissue in a Gallbladder

“…The presence of heterotopic pancreas has been described in the stomach, duodenum, jejunum, and spleen; it is rarely found in the ileum, liver, gallbladder, bile ducts, mesentery, lungs, mediastinum, and fallopian tubes [1,3,[6][7][8][9]. Approximately 90% of the cases are located in the upper gastrointestinal tract [2].…”

“…Pancreatic heterotopia on the wall of the gallbladder is rare; Jean Schultz first described the condition in 1727, and Klob first confirmed its histopathology in 1859 [1,6,8].…”

“…Ectopic or heterotopic pancreas is an abnormality of embryological origin and is defined as the presence of pancreatic tissue histologically identified outside the normal topography without any anatomical, vascular, or neural connection with the gland [1][2][3][4][5][6][7]. Pancreatic heterotopia on the wall of the gallbladder is rare; Jean Schultz first described the condition in 1727, and Klob first confirmed its histopathology in 1859 [1,6,8].…”