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Mikoviny Kajzrlikova I, Kuchar J, Vitek P, Horavova B, Vankova H, Chrostek M. Endoscopic treatment of pancreatic fluid collection in gastric heterotopic pancreas. A case report. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2024; 168:92-96. [PMID: 36245211 DOI: 10.5507/bp.2022.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Heterotopic pancreas is defined as pancreatic tissue located outside the pancreatic parenchyma that lacks an anatomic or vascular connection to the normal pancreas. Symptomatic gastric heterotopic pancreas is a rare condition that can manifest as acute or chronic pancreatitis. Asymptomatic heterotopic pancreas does not require treatment, while symptomatic lesions should be resected. The modality of final resection of heterotopic pancreas depends on its size and the depth of gastric wall involvement. METHODS AND RESULTS A 36-year-old woman was admitted for recurrent epigastralgia. Abdominal computed tomography (CT) scan revealed that an abscess had formed in the gastric antrum. After multidisciplinary discussion we decided for conservative treatment with intravenous antibiotics and further detailed endoscopic diagnostic. Esophagogastroduodenoscopy revealed a submucosal mass with a central fistula and intermittent pus secretion in the prepyloric region of the gastric antrum, which was subsequently drained with a double pigtail stent under endoscopic ultrasound (EUS) and fluoroscopy. The possibility of pancreatic fluid collection in the case of heterotopic pancreas was suggested during the EUS examination, and histology subsequently confirmed heterotopic pancreatic tissue. The patient was in good condition and without any abdominal pain. According to a control CT scan after 10 weeks, the fluid collection was completely resolved. Due to the possible recurrence of pancreatitis, resection of heterotopic pancreas was proposed to the patient. Since the lesion involved the muscularis propria of the gastric wall, surgical resection of the mass was indicated. CONCLUSION Fluid collections after acute pancreatitis in heterotopic pancreas in the gastric antrum can be successfully managed by endoscopy.
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Affiliation(s)
- Ivana Mikoviny Kajzrlikova
- Department of Internal Medicine, Beskydy Gastrocentre, Hospital Frydek-Mistek, El. Krasnohorske 321, 73801 Frydek-Mistek, Czech Republic
| | - Jan Kuchar
- Department of Internal Medicine, Beskydy Gastrocentre, Hospital Frydek-Mistek, El. Krasnohorske 321, 73801 Frydek-Mistek, Czech Republic
| | - Petr Vitek
- Department of Internal Medicine, Beskydy Gastrocentre, Hospital Frydek-Mistek, El. Krasnohorske 321, 73801 Frydek-Mistek, Czech Republic
- Department of Internal Studies, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Barbora Horavova
- Department of Pathology, Hospital Frydek-Mistek, El. Krasnohorske 321, 73801 Frydek-Mistek, Czech Republic
| | - Hana Vankova
- Department of Radiodiagnostic, Hospital Frydek-Mistek, El. Krasnohorske 321, 73801 Frydek-Mistek, Czech Republic
| | - Martin Chrostek
- Department of Surgery, Hospital Frydek-Mistek, El. Krasnohorske 321, 73801 Frydek-Mistek, Czech Republic
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Khalyfa AA, Ahsan N, Inam M, Ayub K. Endoscopic management of tumors of minor ampulla: a multicenter study. Endosc Int Open 2022; 10:E978-E981. [PMID: 35845025 PMCID: PMC9286768 DOI: 10.1055/a-1839-5401] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/20/2022] [Indexed: 11/26/2022] Open
Abstract
Background and study aims Papillary and duodenal carcinoma are aggressive cancers with poor 5-year survival rates. Papillectomy is a well-established treatment for early-stage carcinoma of the major papilla. Tumors arising in the minor papilla are relatively rare and there is little research available on the endoscopic management of these tumors. Patients and methods The purpose of this study was to establish the safety and efficacy of endoscopic papillectomy in the management of minor papillary tumors. A total of six patients undergoing ERCP for papillectomy for minor papillary tumor at four hospitals were included in this study over a period of 5 years. Results Papillectomy was technically successful in all six patients. Pathology revealed adenoma in three patients, adenoma with high-grade dysplasia in one patient, carcinoma in one patient, and carcinoid tumor in one patient. For follow-up, one patient had an additional tumor identified at 2 years which was found to be a recurrence of the original adenoma. This patient was treated with repeat papillectomy with no further evidence of recurrence. Conclusions In our pilot study, we demonstrate that endoscopic papillectomy appears safe and effective in the management of minor papillary tumors.
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Affiliation(s)
- Ahamed A. Khalyfa
- Franciscan Saint James Health Olympia Fields Campus, Gastroenterology
| | - Nayab Ahsan
- Southwest Gastroenterology, Gastroenterology
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LeCompte MT, Mason B, Robbins KJ, Yano M, Chatterjee D, Fields RC, Strasberg SM, Hawkins WG. Clinical classification of symptomatic heterotopic pancreas of the stomach and duodenum: A case series and systematic literature review. World J Gastroenterol 2022; 28:1455-1478. [PMID: 35582670 PMCID: PMC9048474 DOI: 10.3748/wjg.v28.i14.1455] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/11/2021] [Accepted: 03/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Heterotopic pancreas (HP) is an aberrant anatomic malformation that occurs most commonly in the upper gastrointestinal tract. While the majority of heterotopic pancreatic lesions are asymptomatic, many manifest severe clinical symptoms which require surgical or endoscopic intervention. Understanding of the clinical manifestations and symptoms of HP is limited due to the lack of large volume studies in the literature. 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 disease.
AIM To classify the common clinical manifestations of heterotopic pancreas.
METHODS A retrospective review was conducted of pathologic samples containing heterotopic pancreas from 2000-2018. Review was limited to HP of the upper gastrointestinal tract due to the frequency of presentation in this location. Symptomatic patients were identified from review of the medical records and clinical symptoms were tabulated. These were compared to a systematic review of the literature utilizing PubMed and Embase searches for papers pertaining to heterotopic pancreas. Publications describing symptomatic presentation of HP were selected for review. Information including demographics, symptoms, presentation and treatment were compiled and analyzed.
RESULTS Twenty-nine patient were identified with HP at a single center, with six of these identified has having clinical symptoms. Clinical manifestations included, gastrointestinal bleeding, gastric ulceration with/without perforation, pancreatitis, and gastric outlet obstruction. Systemic review of the literature yielded 232 publications detailing symptomatic cases with only 20 studies describing ten or more patients. Single and multi-patient studies were combined to form a cohort of 934 symptomatic patients. The majority of patients presented with abdominal pain (67%) combined with one of the following clinical categories: (1) Dyspepsia, (n = 445, 48%); (2) Pancreatitis (n = 260, 28%); (3) Gastrointestinal bleeding (n = 80, 9%); and (4) Gastric outlet obstruction (n = 80, 9%). The majority of cases (n = 832, 90%) underwent surgical or endoscopic resection with 85% reporting resolution or improvement in their symptoms.
CONCLUSION Heterotopic pancreas can cause significant clinical symptoms in the upper gastrointestinal tract. Better understanding and classification of this disease may result in more accurate identification and treatment of this malformation.
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Affiliation(s)
- Michael T LeCompte
- Department of Surgical Oncology, University of North Carolina, Raleigh, NC 27608, United States
| | - Brandon Mason
- Department of Radiology, Stillwater Medical Center, Stillwater, OK 74074, United States
| | - Keenan J Robbins
- Department of General Surgery, Washington University St. Louis, St. Louis, MO 63110-8109, United States
| | - Motoyo Yano
- Department of Radiology, Mayo Clinic, Phoenix, AZ 8505, United States
| | - Deyali Chatterjee
- Department of Pathology and Immunology, MD Anderson Cancer Center, Houston, TX 77030, United States
| | - Ryan C Fields
- Department of Surgical Oncology, Washington University School of Medicine, St. Louis, MO 63110-8109, United States
| | - Steven M Strasberg
- Section of Hepatobiliary-Pancreatic and GI Surgery, Washington University St. Louis, St. Louis, MO 63110, United States
| | - William G Hawkins
- Section of Hepatobiliary-Pancreatic and GI Surgery, Washington University St. Louis, St. Louis, MO 63110, United States
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Nguyen TL, Kapur S, Schlack-Haerer SC, Gurda GT, Folkers ME. Unusual Tissue - Unusual Issue: Pancreatic Heterotopia Presenting as Gastric Outlet Obstruction. Case Rep Gastroenterol 2021; 15:338-343. [PMID: 33790723 PMCID: PMC7989796 DOI: 10.1159/000512427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 10/16/2020] [Indexed: 11/19/2022] Open
Abstract
Pancreatic heterotopia (PH) is a common, but typically small (<1 cm), incidental and asymptomatic finding; however, PH should be considered even for large and symptomatic upper gastrointestinal masses. A 27-year-old white woman presented with a 3-week history of burning epigastric pain, nausea, early satiety, and constipation. Physical examination revealed epigastric and right upper quadrant tenderness with normal laboratory workup, but imaging revealed a 5-cm, partly cystic mass arising from the gastric antrum with resulting pyloric stenosis and partial gastric outlet obstruction. Endoscopic ultrasound-guided fine needle aspiration revealed PH − an anomalous pancreatic tissue lying in a nonphysiological site. The patient ultimately underwent a resection and recovered uneventfully, with a complete pathologic examination revealing normal exocrine pancreatic tissue (PH type 2) without malignant transformation. We report a case of heterotopic pancreas manifesting as severe gastric outlet obstruction, in addition to a thorough diagnostic workup and surgical follow-up, in a young adult. Differential diagnoses and features that speak to benignity of a large, symptomatic mass lesion (PH in particular) are discussed.
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Affiliation(s)
- Thu L Nguyen
- Division of Medical Education, Department of Internal Medicine, Gundersen Health System, La Crosse, Wisconsin, USA
| | - Shivani Kapur
- Division of Medical Education, Department of Internal Medicine, Gundersen Health System, La Crosse, Wisconsin, USA
| | - Stephen C Schlack-Haerer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Gundersen Health System, La Crosse, Wisconsin, USA
| | - Grzegorz T Gurda
- Department of Pathology, Gundersen Health System, La Crosse, Wisconsin, USA.,Gundersen Medical Foundation, Kabara Cancer Research Institute, La Crosse, Wisconsin, USA
| | - Milan E Folkers
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Gundersen Health System, La Crosse, Wisconsin, USA
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Lee HS, Kim DH, Park SY, Kim S, Kim GT, Cho E, Yoon JH, Park CH, Kim HS, Choi SK, Kim NI, Rew JS. Endoscopic and Endosonographic Features of Histologically Proven Gastric Ectopic Pancreas by Endoscopic Resection. THE KOREAN JOURNAL OF GASTROENTEROLOGY = TAEHAN SOHWAGI HAKHOE CHI 2020; 76:9-16. [PMID: 32703915 DOI: 10.4166/kjg.2020.76.1.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/26/2020] [Accepted: 04/27/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUNDS/AIMS Distinguishing gastric ectopic pancreas (GEP) from malignant tumors is relatively difficult. This study evaluated the endosonography findings of pathologically proven GEP. METHODS Thirty-one patients diagnosed with GEP based on a histopathological analysis from January 2004 to July 2018 were enrolled in this study. All patients underwent EUS and an endoscopic resection. RESULTS Seventeen patients were female, and the median age was 41.1 years (range, 14-74). The lesions were localized most commonly in the antrum. The mean size of the GEP was 10.6 mm (range, 7-15). Superficial type lesions, lesions with heterogeneous echogenicity, mixed pattern lesions, and lesions with indistinct borders were commonly observed on EUS. Calcification, anechoic duct-like structures, and thickening of the muscularis propria were observed in some patients. Endoscopic mucosal resection (41.9%) and endoscopic submucosal dissection (58.1%) were performed. The mean procedure time was 22.5 minutes. Complete resection was achieved for 71% of patients. No statistically significant results between the endosonography findings and complete resection rates were obtained. The mean follow-up esophagogastroduodenoscopy duration was 4.5 months. None of the patients presented with residual lesions on subsequent endoscopy. CONCLUSIONS EUS can help identify the features of GEP. Careful observations of the EUS findings can avoid unnecessary removal of GEP.
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Affiliation(s)
- Ho-Sung Lee
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Dong Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Seon-Young Park
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Sunmin Kim
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Gwang Taek Kim
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Eunae Cho
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Jae Hyun Yoon
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Chang Hwan Park
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Hyun Soo Kim
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Sung Kyu Choi
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Nah Ihm Kim
- Department of Pathology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Jong Sun Rew
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
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Misheva B, Hajjar R, Chapdelaine H, Sebajang H, Schwenter F. Ectopic jejunal pancreas with pancreatitis mistaken for a post-transplant lymphoproliferative disease in an immunosuppressed kidney transplant patient. J Surg Case Rep 2018; 2018:rjy259. [PMID: 30310646 PMCID: PMC6172697 DOI: 10.1093/jscr/rjy259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 09/12/2018] [Indexed: 12/14/2022] Open
Abstract
An ectopic pancreas, also known as pancreatic rest or heterotopic pancreas, consists of pancreatic tissue found in a location with no continuity with the anatomic pancreas. This lesion can occasionally cause gastrointestinal obstruction, ulceration or become inflamed and cause ectopic pancreatitis. We present the case of a 29-year-old immunocompromised female patient due to a previous kidney transplant. She presented with nausea and vague abdominal discomfort and was admitted for investigation and treatment of an acute kidney injury. A small bowel mass of unknown etiology was incidentally found on abdominal computed tomography imaging. Due to the high suspicion of a post-transplant lymphoproliferative disease, a surgical exploration took place and revealed the presence of a pancreatic rest with chronic pancreatitis. Ectopic pancreas diagnosis is challenging and surgical exploration is warranted when a neoplastic process is suspected.
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Affiliation(s)
- Bojana Misheva
- Université de Montréal, Faculté de Médecine, Centre Hospitalier de l'Université de Montréal (CHUM), Service de Chirurgie Digestive, 1051 rue Sanguinet, Montréal, Québec, Canada
| | - Roy Hajjar
- Université de Montréal, Programme de Chirurgie Générale Centre Hospitalier de l'Université de Montréal (CHUM), Service de Chirurgie Digestive, 1051 rue Sanguinet, Montréal, Québec, Canada
| | - Hugo Chapdelaine
- Clinique Immunodéficience Primaire de l'adulte, Institut de Recherches Cliniques de Montréal, Centre Hospitalier de l'Université de Montréal (CHUM), 1051 rue Sanguinet, Montréal, Québec, Canada
| | - Herawaty Sebajang
- Centre Hospitalier de l'Université de Montréal (CHUM), Service de chirurgie digestive, 1051 rue Sanguinet, Montréal, Québec, Canada
| | - Frank Schwenter
- Centre Hospitalier de l'Université de Montréal (CHUM), Service de chirurgie digestive, 1051 rue Sanguinet, Montréal, Québec, Canada
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Minor Papilla Adenoma Management in Patients with Pancreas Divisum and Familial Adenomatous Polyposis. ACG Case Rep J 2013; 1:47-50. [PMID: 26157819 PMCID: PMC4435256 DOI: 10.14309/crj.2013.17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 09/23/2013] [Indexed: 12/18/2022] Open
Abstract
Several case reports on endoscopic resection of minor papilla adenomas exist in the literature. However, there are no reported cases of endoscopic resection in patients with minor papilla adenomas with associated familial adenomatous polyposis (FAP) and pancreas divisum. We report a case of a minor papilla adenoma in a patient with FAP and pancreas divisum. The case demonstrates a new association between these disease processes. Defining pancreatic ductal anatomy prior to endoscopic intervention is essential. In addition, we demonstrate the safety and feasibility of endoscopic management of minor papilla tumors in patients with FAP and associated pancreas divisum.
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Ha DW, Kim GH, Kim DU, Bae MJ, Kim BW, Jeon HK, Park DY, Seo HI. A Case of a Neuroendocrine Carcinoma in the Minor Papilla. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2011; 58:144-8. [DOI: 10.4166/kjg.2011.58.3.144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Dong Woo Ha
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Gwang Ha Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Dong Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Min Jung Bae
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Bo Won Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Hye Kyung Jeon
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Do Yun Park
- Department of Pathology, Pusan National University School of Medicine, Busan, Korea
| | - Hyung Il Seo
- Department of Surgery, Pusan National University School of Medicine, Busan, Korea
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Trevino JM, Wilcox CM, Varadarajulu S. Endoscopic resection of minor papilla adenomas (with video). Gastrointest Endosc 2008; 68:383-386. [PMID: 18582882 DOI: 10.1016/j.gie.2008.03.1070] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2008] [Accepted: 03/09/2008] [Indexed: 12/18/2022]
Abstract
BACKGROUND Although there are several large series on endoscopic resection of the major duodenal papilla, only commentary on individual cases has been presented on endoscopic minor papilla resection. OBJECTIVE To evaluate the technical success and safety of endoscopy for resection of minor papilla adenomas. DESIGN Observational study. SETTING Academic tertiary-referral center. PATIENTS Consecutive patients referred for endoscopic resection of minor papilla adenomas over a 12-month period. INTERVENTIONS All patients underwent an EUS before an ERCP to exclude ductal involvement by the tumor and for evaluation of pancreatic-ductal anatomy. The minor papilla was removed by snare electrocautery in all patients. A pancreatic stent was placed in the dorsal duct in patients with pancreas divisum as a prophylaxis for post-ERCP pancreatitis. Complications were assessed per consensus criteria. MAIN OUTCOME MEASUREMENTS To evaluate the technical success and safety of endoscopy for resection of minor papilla adenomas. OBSERVATIONS Three patients underwent endoscopic resection of minor papilla adenomas over a 12-month period. The first patient had minor papilla adenoma, the second had coexisting pancreas divisum anatomy, and the third had adenomatous involvement of both the major and minor papillas. Minor papilla resection was technically successful in all 3 patients, with dual major and minor papilla resection in 1 patient who had adenomatous changes at both sites. Although 2 patients experienced no complications, the patient with pancreas divisum developed mild post-ERCP pancreatitis. At a 12-month follow-up, there was no evidence of tumor recurrence in any of the 3 patients. LIMITATION Small number of patients. CONCLUSIONS In experienced hands, endoscopic resection of the minor papilla is technically feasible, safe, and is associated with favorable clinical outcomes.
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Affiliation(s)
- Jessica M Trevino
- Division of Gastroenterology-Hepatology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama 35294, USA
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Wall I, Shah T, Tangorra M, Li JJ, Tenner S. Giant heterotopic pancreas presenting with massive upper gastrointestinal bleeding. Dig Dis Sci 2007; 52:956-9. [PMID: 17342389 DOI: 10.1007/s10620-006-9481-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2006] [Accepted: 06/11/2006] [Indexed: 01/29/2023]
Abstract
Heterotopic pancreas, or pancreatic rest, refers to extra-pancreatic tissue without an obvious vascular or anatomic connection with the pancreas. Although the frequency of heterotopic pancreatic tissue in autopsy series has been reported as high as 14%, clinical manifestations are rare [2]. Although common in the upper gastrointestinal tract, heterotopic pancreatic tissue rarely causes gastrointestinal bleeding. In a large case series following patients with heterotopic pancreatic tissue, only 7 of 212 patients had any evidence of bleeding [3]. We present a patient who presented with massive hematochezia found to have a giant heterotopic pancreas in the duodenum.
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Affiliation(s)
- Ian Wall
- Division of Gastroenterology, Department of Medicine, Maimonides Medical Center Brooklyn, New York, NY 11219, USA
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Tanemura A, Yano T, Tamaki H, Sanda T, Ohashi N, Ishihara A, Fukutome K, Shiraki K. Ectopic pancreas in the minor duodenal papilla presenting as upper-GI bleeding. Gastrointest Endosc 2005; 62:324-6. [PMID: 16047011 DOI: 10.1016/s0016-5107(05)01571-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Yamao K, Ohhashi K, Furukawa T, Mizutani S, Matsumoto S, Banno T, Fujimoto M, Hayakawa T. Primary carcinoma of the duodenal minor papilla. Gastrointest Endosc 1998; 48:634-6. [PMID: 9852458 DOI: 10.1016/s0016-5107(98)70050-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- K Yamao
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
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