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Ectopic pancreatic tissue

Ectopic pancreatic tissue (or heterotopic pancreatic tissue) refers to the situation where rests of pancreatic tissue lie outside and separate to the pancreatic gland. Most patients are completely asymptomatic.

Epidemiology

It is reportedly relatively common, affecting ~5% (range 1-10%) 1 of people. 

Gross anatomy

Recognised locations for ectopic pancreatic tissue include : 

If the ectopic pancreatic tissue is functional, it is subject to the same variation of pathology that affects the normal gland, including, but not limited to pancreatitis and pancreatic tumours.

Radiographic features

On upper gastrointestinal examination, an ectopic pancreas appears as an extramucosal, smooth, broad-based lesion either along the greater curvature of the gastric antrum or in the proximal duodenum.

Barium study

In 45% of the cases of ectopic pancreas discovered on upper gastrointestinal examination, the ectopic pancreatic tissue contains a central small collection of barium, which is indicative of a central niche or umbilication. It is this finding that is diagnostic of ectopic pancreatic tissue.

CT

Contrast enhanced CT may show a homogeneously enhancing tissue (similar to normal pancreas) or cystic area (acinar component or pseudocyst).

Treatment and prognosis

Laparoscopic wedge resection is usually successful in removing the ectopic tissue, although its success is dependent on the location.


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