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Advances in the diagnosis and treatment of heterotopic pancreas

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World Journal of Clinical Cases 2024年第30期12卷 6349-6352页

作者： Li Lang Fa-Kun Yu Li-Min Kang Department of Outpatient Puer People's HospitalPuer 665000Yunnan ProvinceChina Department of Hepatobiliary and Pancreatic Surgery Puer People's HospitalPuer 665000Yunnan ProvinceChina

heterotopic pancreas,a rare congenital malformation,manifests outside the normal *** suggests that abnormal embryonic development is linked to the presence of heterotopic *** prevailing theories explain its mechanism:Dislocation theory,metaplasia theory,and totipotent stem cell *** presentations of heterotopic pancreas are often nonspecific,with most patients being asymptomatic and incidentally discovered during unrelated surgeries or *** ultrasound,computed tomography,and magnetic resonance imaging are commonly employed diagnostic tools for heterotopic ***,the accuracy of diagnosis based on these methods is not consistently high,necessitating histopathological confirmation in many *** options for heterotopic pancreas typically involve endoscopic resection,surgical resection,or observation through follow-up.

关键词： heterotopic pancreas Ultrasound endoscopy Enhanced computed tomography Endoscopic therapy Surgery

heterotopic pancreas adenocarcinoma in the stomach: A case report and literature review

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World Journal of Clinical Cases 2020年第10期8卷 1979-1987页

作者： Yao Xiong Yue Xie Dan-Dan Jin Xin-Ying Wang Department of Gastroenterology Zhujiang Hospital of Southern Medical UniversityGuangzhou 510280Guangdong ProvinceChina

BACKGROUND heterotopic pancreas is a common lesion found in the gastrointestinal tract and is usually considered a benign *** of malignant change of heterotopic pancreas are *** SUMMARY A 44-year-old Chinese female underwent a gastroscopy to assess abdominal distension that had persisted for 2 months.A protruding lesion in the gastric antrum was revealed but no malignant tissue was found in the biopsy *** patient's symptom persisted and progressed to repeated *** after 4 months revealed obstruction of the gastric outlet caused by the protruding lesion.A distal gastrectomy was *** examination of the surgical specimen showed the malignant transformation of aberrant pancreas in the *** consisting of folinic acid,fluorouracil,and oxaliplatin was administered for three cycles,and was changed to gemcitabine monotherapy because of adverse effects and increased serum tumor marker *** patient remained asymptomatic during a 12-month *** Pancreatic heterotopy should be considered as source of a potentially malignant lesion,and early treatment or close monitoring for aberrant pancreas is recommended.

关键词： Stomach Pyloric obstruction heterotopic pancreas Adenocarcinoma Case report

heterotopic pancreas: report of 7 patients

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Hepatobiliary & Pancreatic Diseases International 2002年第2期1卷 299-301页

作者： Hong-Qi Shi Qi-Yu Zhang Hong-Lin Teng Ji-Cai Chen From the Department of General Surgery, First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, China Department of General Surgery First Affiliated Hospital of Wenzhou Medical College Wenzhou 325000 China. shhq802260451@ ***

Objective: To discuss the clinical features of patients with heterotopic pancreas, their diagnosis and surgi- cal treatment. Methods: Seven patients with heterotopic pancreas were treated surgically in our hospital from August 1992 to March 1999. Results: Of the 7 patients, 4 had heterotopic pancre- as located in the duodenum, 2 in the jejunum, and 1 in the stomach. Four patients experienced abdominal pain, 3 icterus, 1 duodenal obstruction, and 1 diges- tive tract bleeding. Three patients were complicated by cholelithiasis, and 1 patient was complicated by diverticulum of the jejunum. All seven patients were misdiagnosed or undefined preoperatively. They un- derwent surgery and were confirmed pathologically. Conclusions: heterotopic pancreas is extremely diffi- cult to diagnose before operation since no specific clinical signs are seen in such patients. Once diag- nosed with symptoms or not, the patients should un- dergo surgery for correct diagnosis and avoidance of relative complications.

关键词： heterotopic pancreas clinical manifestation diagnosis therapy

Interventional endoscopic ultrasound for a symptomatic pseudocyst secondary to gastric heterotopic pancreas

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World Journal of Gastroenterology 2017年第34期23卷 6365-6370页

作者： hang-bin jin lei lu jian-feng yang qi-feng lou jing yang hong-zhang shen xiao-wei tang xiao-feng zhang Department of Gastroenterology Hangzhou First People’s HospitalNanjing Medical University

heterotopic pancreas(HP) is a relatively uncommon entity that is defined as pancreatic tissue without a true anatomical or vascular connection to the pancreas. HP does not cause symptoms in most cases but can occasionally produce various manifestations, including nausea, vomiting, abdominal pain, and even heterotopic pancreatitis. Here, we report an unusual case in which heterotopic pancreatitis complicated by the formation of a pseudocyst that caused gastric outlet obstruction was diagnosed based on serum hyperamylasemia and findings from endoscopic ultrasonography(EUS)-guided fine needle aspiration(EUS-FNA) cytology. EUS-guided single pigtail stent insertion was successfully performed for recurrent gastric outlet obstruction. The patient has remained healthy and symptom-free during 4 years of surveillance. In the context of the relevant literature, the described case is a rare case of HP complicated by a pseudocyst treated via EUS-FNA and stent insertion.

关键词： heterotopic pancreas Pseudocyst gastric outlet obstruction Endoscopic ultrasound-guided fine needle aspiration

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

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World Journal of Clinical Cases 2018年第14期6卷 847-853页

作者： Xiao-Bing Tang Min-Yi Liao Wei-Lin Wang Yu-Zuo Bai Department of Pediatric Surgery Shengjing HospitalChina Medical University

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. In-volvement 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 diffcult, even in a symptomatic patient. Increased awarenessand understanding of the image characteristics of MHP will aid in correct preoperative diagnosis and appropriate patient management.

关键词： heterotopic pancreas Mesenteric Acute abdomen Computed tomography Magnetic resonance imaging Case report

Asymptomatic gastric adenomyoma and heterotopic pancreas in a patient with pancreatic cancer: A case report and review of the literature

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World Journal of Clinical Cases 2021年第27期9卷 8147-8156页

作者： Kun Li Yan Xu Nan-Bin Liu Bao-Min Shi Department of General Surgery Tongji Hospital of Tongji UniversityShanghai 200065China

BACKGROUND Gastric adenomyoma(GA)is a rare submucosal benign neoplasm that occurs mostly in the gastric antrum and is often *** standard treatment has been established for this disease in cases of *** SUMMARY A 75-year-old woman with a 10-year history of hypertension was admitted to the Emergency Department of our hospital complaining of paroxysmal exacerbation of acute abdominal pain for 1 d with no apparent *** computed tomography and magnetic resonance imaging indicated a mass in the caudal pancreas,cholecystitis,and cholecystic *** endoscopy showed a mass arising from the gastric *** to the imaging findings,pancreatic cancer(PC),gastric lesion,cholecystitis,and cholecystic polypus were our primary *** pancreatectomy,splenectomy,and cholecystectomy were performed successfully,and the gastric tumor was locally *** paraffin specimens confirmed the diagnosis of caudal PC,GA,and heterotopic pancreas(HP).Unfortunately,the patient died 13 mo later due to PC metastases to the liver,lung,and adrenal *** GA is a rare benign disease,especially when occurring with *** may stem from the same origin as *** is the first case report to date of a patient suffering from the simultaneous occurrence of GA,HP,and *** is a lesion that can mimic other benign or malignant gastrointestinal diseases;thus,a definitive diagnosis depends on postoperative pathological *** GA and HP are both benign lesions,they should be resected because there is a chance of *** research should be conducted to better understand these submucosal lesions.

关键词： Gastric adenomyoma heterotopic pancreas Case report Literature review Radiological performance Pathological performance

Endoscopic submucosal dissection as alternative to surgery for complicated gastric heterotopic pancreas

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World Journal of Clinical Cases 2020年第20期8卷 4708-4718页

作者： Jin Hee Noh Do Hoon Kim So-Woon Kim Young Soo Park Hee Kyong Na Ji Yong Ahn Kee Wook Jung Jeong Hoon Lee Kee Don Choi Ho June Song Gin Hyug Lee Hwoon-Yong Jung Department of Gastroenterology University of Ulsan College of MedicineAsan Medical CenterSeoul 05505South Korea Department of Pathology University of Ulsan College of MedicineAsan Medical CenterSeoul 05505South Korea

BACKGROUND Gastric heterotopic pancreas(GHP)is generally asymptomatic and rarely features complications such as pancreatitis,pseudocysts,gastric outlet obstruction,bleeding,obstructive jaundice,or ***,the treatment of complicated GHP is challenging and often requires surgical *** To investigate the clinical outcomes of endoscopic submucosal dissection(ESD)as alternative to surgical resection for complicated *** This is a single-center,retrospective *** January 2013 and December 2017,a total of 5 patients underwent ESD for complicated GHP at Asan Medical *** who were diagnosed with complicated GHP were treated conservatively as with general practice for acute *** conservative management for resolving the acute phase of pancreatitis,ESD was performed as definitive treatment for complicated *** was performed using the conventional method under conscious *** clinical features of patients and tumors,procedure-related characteristics,and long-term outcomes were *** The age of the 5 patients ranged from 28-43 *** of the patients were *** lesions were located in the greater curvature of the *** endoscopic ultrasonography during the pain episode,all lesions were located across the muscularis mucosa,submucosa,and proper muscle *** median lesion size was 20[interquartile range(IQR),18-35]during the pain episode at the time of the diagnosis of complicated GHP,and 15 mm(IQR,9-33)at the time of ESD after conservative *** procedure time ranged from 15-120 *** were no procedure-related adverse events such as perforation or *** length of hospital stay after the procedure ranged from 2-4 *** patients were symptom free during the median follow-up period of 46.0 mo(IQR,39-60).CONCLUSION ESD appears to be a feasible and effective treatment option for complicated GHP based on the favorable clinical outcomes.

关键词： Endoscopic submucosal dissection Gastric heterotopic pancreas Pancreatitis

Clinical classification of symptomatic heterotopic pancreas of the stomach and duodenum:A case series and systematic literature review

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World Journal of Gastroenterology 2022年第14期28卷 1455-1478页

作者： Michael T Le Compte Brandon Mason Keenan J Robbins Motoyo Yano Deyali Chatterjee Ryan C Fields Steven M Strasberg William G Hawkins Department of Surgical Oncology University of North CarolinaRaleighNC 27608United States Department of Radiology Stillwater Medical CenterStillwaterOK 74074United States Department of General Surgery Washington University St.LouisSt.LouisMO 63110-8109United States Department of Radiology Mayo ClinicPhoenixAZ 8505United States Department of Pathology and Immunology MD Anderson Cancer CenterHoustonTX 77030United States Department of Surgical Oncology Washington University School of MedicineSt.LouisMO 63110-8109United States Section of Hepatobiliary-Pancreatic and GI Surgery Washington University St.LouisSt.LouisMO 63110United States

BACKGROUND heterotopic pancreas(HP)is an aberrant anatomic malformation that occurs most commonly in the upper gastrointestinal *** the majority of heterotopic pancreatic lesions are asymptomatic,many manifest severe clinical symptoms which require surgical or endoscopic *** of the clinical manifestations and symptoms of HP is limited due to the lack of large volume studies in the *** purpose of this study is to review symptomatic cases at a single center and compare these to a systematic review of the literature in order to characterize common clinical manifestations and treatment of this *** To classify the common clinical manifestations of heterotopic *** A retrospective review was conducted of pathologic samples containing heterotopic pancreas from *** was limited to HP of the upper gastrointestinal tract due to the frequency of presentation in this *** patients were identified from review of the medical records and clinical symptoms were *** were compared to a systematic review of the literature utilizing Pub Med and Embase searches for papers pertaining to heterotopic *** describing symptomatic presentation of HP were selected for *** including demographics,symptoms,presentation and treatment were compiled and *** Twenty-nine patient were identified with HP at a single center,with six of these identified has having clinical *** manifestations included,gastrointestinal bleeding,gastric ulceration with/without perforation,pancreatitis,and gastric outlet *** review of the literature yielded 232 publications detailing symptomatic cases with only 20 studies describing ten or more *** and multi-patient studies were combined to form a cohort of 934 symptomatic *** majority of patients presented with abdominal pain(67%)combined with one of the following clinical catego

关键词： heterotopic pancreas Ectopic pancreas Aberrant pancreas Pancreatic rest Groove pancreatitis

Intraductal papillary mucinous neoplasm originating from a jejunal heterotopic pancreas:A case report

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World Journal of Clinical Cases 2023年第11期11卷 2496-2501页

作者： Jun-Hao Huang Wei Guo Zhe Liu Department of Pancreatic-Biliary Surgery The First Hospital of China Medical UniversityShenyang 110001Liaoning ProvinceChina

BACKGROUND Intraductal papillary mucinous neoplasm(IPMN)is a rare pancreatic tumor and has the potential to become *** is the most effective treatment at present,but there is no consensus on the site of *** pancreas occurs in the gastrointestinal tract,especially the stomach and duodenum but is asymptomatic and *** report a case of ectopic pancreas with IPMN located in the *** SUMMARY A 56-year-old male patient suffered from severe pain,nausea and vomiting due to a traffic accident and sought emergency treatment at our ***-enhanced computed tomography of the whole abdomen suggested splenic congestion,which was considered to be splenic *** laparotomy was performed,and the ruptured spleen was removed during the ***,a cauliflower-like mass of about 2.5 cm×2.5 cm in size was incidentally found about 80 cm from the ligament of Treitz during the operation.A partial small bowel resection was performed,and postoperative pathology confirmed the small bowel mass as heterotopic pancreas with low-grade *** Ectopic pancreas occurs in the jejunum and is pathologically confirmed as IPMN after surgical resection.

关键词： heterotopic pancreas Intraductal papillary mucinous neoplasm Tumor Case report Pathology Diagnosis