The clinical significance of heterotopic pancreas in the gastrointestinal tract

Abstract

A series of 34 histologically verified cases of pancreatic heterotopia in the records of the Department of Pathology at the University of Edinburgh between 1959 and 1979 has been analysed in order to determine the clinical significance of this unusual condition. In 13 patients (38 per cent) the heterotopic pancreatic tissue was symptomatic (i.e. the symptoms regressed completely on its removal). A correlation has been established between the presence of symptoms, the size of the lesion and the extent of mucosal involvement. Clinically significant lesions are greater than 1.5 cm in maximum diameter and are adjacent to or directly involve the mucosa.

Heterotopic pancreas in the stomach: A case report and literature review

“…Adenocarcinomas arising from ectopic pancreas seem to have a somewhat better prognosis than those arising from the pancreas itself, probably due to earlier presentation [10] . Symptoms depending upon the anatomical location, such as gastric outlet obstruction in a pre-pyloric rest or obstructive jaundice in a bile duct focus, may originate from the mass effect of the tumour [12] and are also related to the size of the lesion. Lesions greater than 1.5 cm in diameter are more likely to cause symptoms [12] .…”

“…Symptoms depending upon the anatomical location, such as gastric outlet obstruction in a pre-pyloric rest or obstructive jaundice in a bile duct focus, may originate from the mass effect of the tumour [12] and are also related to the size of the lesion. Lesions greater than 1.5 cm in diameter are more likely to cause symptoms [12] . Pain is one of the most common symptoms.…”

“…The possible explanation is that the pain is due to endrocrine and exocrine function of the heterotopic pancreatic tissue, and relates to the secretion of hormones and enzymes, being responsible for inflammation or chemical irritation of the involved tissues [13] . Haemorrhage due to mucosal erosion, ulcer formation and perforation especially localized in the small intestine have also been reported [12] . Barium swallow study may show a typical image of a rounded filling defect with central indentation.…”

Gastric outlet obstruction caused by heterotopic pancreas: A case report and a quick review

“…Heartburn and dyspepsia are also frequent for gastric HP, but often there are symptoms due to mechanical obstruction [1] . In the series of 34 patients with pancreatic heterotopia of Armstrong et al, 8 lesions were located in the stomach and 6 of those had produced symptoms [8] .…”

“…Armstrong et al found that symptoms are related to the size of HP lesion. They postulated that size greater than 1.5 cm is more likely to be of clinical significance [8] . Other less common symptoms were bleeding mimicking jejunal tumor [9] , pancreatitis, and malignant transformation [10][11][12] .…”