Ectopic pancreatic tissue
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Ectopic pancreatic tissue, also known as heterotopic pancreatic tissue, refers to the presence of pancreatic tissue in the submucosal, muscularis or subserosal layers of the luminal gastrointestinal tract outside the normal confines of the pancreas and lacking any anatomic or vascular connection with the pancreas proper.
It is reportedly relatively common, affecting ~5% (range 1-10%) 1 of people.
Most commonly an asymptomatic entity.
Recognized locations for ectopic pancreatic tissue include:
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.
Upper GI barium study
In 45% of the cases of ectopic pancreas discovered on upper gastrointestinal fluoroscopic examination, the ectopic pancreatic tissue contained a central small collection of barium, i.e. a central niche or umbilication, indicative of the rudimentary duct’s draining orifice 2. It is this finding that is diagnostic of ectopic pancreatic tissue.
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.
- 1. Wei R, Wang QB, Chen QH et-al. Upper gastrointestinal tract heterotopic pancreas: findings from CT and endoscopic imaging with histopathologic correlation. Clin Imaging. 35 (5): 353-9. doi:10.1016/j.clinimag.2010.10.001 - Pubmed citation
- 2. Maryam Rezvani, Christine Menias, Kumaresan Sandrasegaran, Jeffrey D. Olpin, Khaled M. Elsayes, Akram M. Shaaban. Heterotopic Pancreas: Histopathologic Features, Imaging Findings, and Complications. (2017) RadioGraphics. 37 (2): 484-499. doi:10.1148/rg.2017160091 - Pubmed