Mesenteric heterotopic pancreas in a pediatric patient: A case report and review of literature

Abstract

Heterotopic pancreas (HP) is a congenital anomaly defined as pancreatic tissue that has no contact with the orthotopic pancreas and its own duct system and vascular supply. The most common locations of HP are the upper gastrointestinal tract, specifically, the stomach, duodenum, and proximal jejunum. Involvement of the mesentery is rare. Here, we describe a rare case of mesenteric heterotopic pancreas (MHP) in a 12-year-old girl who presented with acute abdomen. The patient underwent emergency laparotomy, and the mass and adjacent small bowel were resected. Results of the postoperative histopathologic examination confirmed the diagnosis of MHP. Observation of the patient for 12 mo postoperatively showed no evidence of recurrence. Preoperative diagnosis of HP is difficult, even in a symptomatic patient. Increased awareness and understanding of the image characteristics of MHP will aid in correct preoperative diagnosis and appropriate patient management.

The tale of 2 pancreases: Jejunal mesenteric ectopic pancreas causing recurrent ectopic pancreatitis

“…evaluated the CT imaging findings of EP and found that prominent enhancement, ill-defined margins, endoluminal growth pattern, and a ratio of length and width greater than 1.4 were sensitive for distinguishing submucosal EP [11] . On MRI, EP is isointense to the pancreas on all sequences [12] and characteristically high in T1 signal intensity [3] . MRCP is particularly helpful in distinguishing EP from other entities, as it allows for easier detection of a pancreatic duct within the mass when present [13] .…”

“…EP is most commonly found as a submucosal mass in the wall of the stomach, duodenum, or proximal jejunum but can occur elsewhere [2] . Mesenteric location of EP is quite rare with knowledge limited to a few case reports [3] , [4] , [5] . While most cases of EP are asymptomatic, they can present with complications, such as pancreatitis, bowel obstruction, gastrointestinal bleeding, or neoplasia.…”

Esophageal Heterotopic Pancreas in an Asymptomatic 2-Year-Old With VACTERL Association

“…Heterotopic pancreas was first described in 1727 by Jean Schultz ( 8 , 9 ). It is ectopic pancreatic tissue with no anatomic, vascular, or ductal connections to the main pancreatic gland ( 1 , 10 ).…”

“…The most widely held theory, the misplacement theory, postulates that small branches of the pancreatic anlagen remain on the foregut during embryonic rotation and migrate with growth ( 1 , 2 , 8 , 11 ). This theory accounts for heterotopic pancreatic tissue mainly located near the upper GI tract, from derivatives of the foregut ( 8 ). Given the asymptomatic nature of HP, the true incidence is difficult to determine.…”

Acute on chronic pancreatitis affecting the ectopic pancreas located in the jejunal mesentery: A case report

“…Ectopic pancreas rarely occurs outside the gastrointestinal tract, and occurrence within the mesentery, as in the present case, is rare. 6 Although bleeding, acute pancreatitis, and cancer reportedly occur in the ectopic pancreas within the mesentery, chronic pancreatitis progressing over a long period of time and causing further acute exacerbation has never been reported. 7 – 9…”