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Recurrent ectopic pancreatitis of the jejunum and mesentery over a 30-year period

Hepatobiliary & Pancreatic Diseases International 2011年第2期10卷 218-220页

作者： John CT Wong Charlotte Robinson Edward C Jones Alison Harris Charles Zwirewich robert wakefield Richard K Simons Eric M Yoshida Department of Medicine Department of Medicine 2775 Laurel StreetUniversity of British Columbia VancouverBritish ColumbiaCanadaV5Z 1M9 Department of Radiology Department of Medicine 2775 Laurel StreetUniversity of British Columbia VancouverBritish ColumbiaCanadaV5Z 1M9 Department of Pathology and Laboratory Medicine Department of Medicine 2775 Laurel StreetUniversity of British Columbia VancouverBritish ColumbiaCanadaV5Z 1M9 Department of Surgery Department of Medicine 2775 Laurel StreetUniversity of British Columbia VancouverBritish ColumbiaCanadaV5Z 1M9 Division of Gastroenterology Department of Medicine 2775 Laurel StreetUniversity of British Columbia VancouverBritish ColumbiaCanadaV5Z 1M9

BACKGROUND:Ectopic pancreas is defined as pancreatic tissue found outside its usual anatomical position,with no ductal or vascular communication with the native pancreas. We describe a case of ectopic pancreas of the small bowel and mesentery causing recurrent episodes of pancreatitis, initially suspected on computed tomography(CT)and magnetic resonance cholangiopancreatography(MRCP),and confirmed on histological review of the resection. METHODS:A 67-year-old woman presented with clinical symptoms and biochemical evidence of pancreatitis.She had similar episodes over the past 30 years with unrevealing investigations,and was concluded to have idiopathic pancreatitis. She underwent CT and MRCP,with findings suggestive of ectopic pancreas,a diagnosis confirmed on histology of the resection. RESULTS:MRCP identified a mass in the proximal small bowel mesentery isointense to the native pancreas,with a small duct draining into a proximal jejunal loop.The resected specimen consisted of normal parenchyma with lobulated acinar tissue with scattered islets of Langerhans,an occasional ductular structure,and admixed areas of adipose tissue.The patient remained asymptomatic with normal biochemistry six months post-operatively. CONCLUSION:In an individual with abdominal pain,elevated serum amylase/lipase,but imaging findings of a normal native pancreas,ectopic pancreatitis should be considered,and can be evaluated by CT and MRCP.

关键词： ectopic pancreas gastrointestinal tract endoscopic ultrasound computed tomography magnetic resonance cholangiopancreatography

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