Heterotopic pancreatic tissue in the gastric antrum an incidental finding during bariatric surgery: A case report and literature review

Alqahtani, Awadh; Aljohani, Emad; Almadi, Fahad; Billa, Srikar; Alqahtani, Mohammad; Alkhaldi, Hisham

doi:10.1016/j.ijscr.2019.12.040

Cited by 10 publications

(15 citation statements)

References 7 publications

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“…It The true incidence of heterotopic pancreas is difficult to determine, as most affected patients are asymptomatic. Most of EP lesions do not cause symptoms and are incidentally detected during abdominal surgeries for other indications [ 3 ]. The frequent complications associated with EP include gastrointestinal bleeding, development of intussusception, bowel obstruction and bowel perforation [ 1 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Histologically, the lesions will show the presence of pancreatic acini, ducts and/or islet cells. They can be classified in to four types depending on the pancreatic elements present in the lesion as described by Heinrich et al [ 3 , 7 ]. In the current case, the pancreatic acini and ducts were seen and classified as Type 2 EP.…”

Section: Discussionmentioning

confidence: 99%

“…The reported incidence of EP at autopsy is 0.6–14% and it is estimated to be incidentally detected during 0.2% of upper abdominal surgeries [ 2 ]. The most common sites of EP are the stomach, duodenum and small intestine but it can be found in the esophagus, ileum, and biliary tree [ 3 ]. We present the case of a 16-year-old female with a heterotopic pancreas in the jejunum revealed by occult gastrointestinal bleeding.…”

Section: Introductionmentioning

confidence: 99%

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Ectopic pancreas: A rare cause of occult gastrointestinal bleeding

Ammar

Said

Mizouni

et al. 2020

Annals of Medicine and Surgery

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Ectopic pancreas (EP) is a rare entity characterized by the development of pancreatic tissue in areas other than the pancreas. We present the case of a 16-year-old female with a heterotopic pancreas in the jejunum revealed by occult gastrointestinal bleeding. Contrast-enhanced computed tomography (CT) of the abdomen revealed a 2 × 3 cm enhancing nodular jejunal mass suspicious of a neuroendocrine or gastrointestinal stromal tumor. Octreoscan was planned but the patient presented in the emergency department with fever and sudden onset severe abdominal pain. The patient underwent emergency laparotomy. On abdominal exploration, appendicular perforation was present for which appendectomy and peritoneal lavage were performed. The small jejunal lesion seen on CT was identified during surgery and segmental jejunal resection with end-to-end anastomosis was performed. The histopathological examination of the jejunal mass revealed the presence of pancreatic acini and ductal structures without islets of Langerhans in the submucosa of the small intestine covered by normal mucosa. At the last follow-up of eight months after surgery, the patient is symptom-free and the abdominal CT is normal. Preoperative diagnosis of EP requires high clinical suspicion and should be included in the differential diagnosis while treating patients with gastrointestinal bleeding or gastrointestinal mass on CT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ectopic pancreas: A rare cause of occult gastrointestinal bleeding

Ammar

Said

Mizouni

et al. 2020

Annals of Medicine and Surgery

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“…However, for lesions larger than 3 cm, lesions with histopathological evidence of malignancy or those present in the muscle itself, either subserous or serous, even if they are asymptomatic, must be resected, preferably by laparoscopic access [ 15 , 16 ]. Similarly, lesions incidentally identified during the surgical procedure should also be treated [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…The scientific papers about EP in Bariatric Surgery consisted of intraoperative findings [ [5] , [6] , [7] , [8] ] and, in two cases, in which the initial strategy was the SG, it was necessary to change the surgical approach [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Management of gastric ectopic pancreas identified in preoperative evaluation of bariatric surgery – A case report

Silva

Oliveira

Jucá

et al. 2020

International Journal of Surgery Case Reports

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Highlights The diagnosis of rare gastric lesions has become more frequent after the increase in bariatric surgery. The preoperative evaluation for bariatric surgery showed two lesions suggestive of Gastric Ectopic Pancreas. The previous identification of these lesions provides better surgical planning. Intraoperative Upper Endoscopy was used to identify the location of these lesions. Simultaneous laparoscopic resection of the lesions associated with Sleeve Gastrectomy was performed.

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