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Emergency Presentation of Gastric Ectopic Pancreas

Ectopic pancreas is a rare embryological abnormality apparently not in association with others. Stomach and duodenum are the most common organs involved. Symptoms are nonspecific. Patients may complain of dyspepsia, abdominal pain or intestinal obstruction. Malignant evolution of ectopic pancreatic...

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Autores principales: Calcagno, Pietro, Lotti, Marco, Campanati, Luca, Greco, Salvatore, Trezzi, Rosangela, Assolari, Andrea, Vaterlini, Elisa, Bertani, Cristina, Allievi, Niccolò, Giulii Capponi, Michela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6325026/
https://www.ncbi.nlm.nih.gov/pubmed/30648097
http://dx.doi.org/10.7759/cureus.3565
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author Calcagno, Pietro
Lotti, Marco
Campanati, Luca
Greco, Salvatore
Trezzi, Rosangela
Assolari, Andrea
Vaterlini, Elisa
Bertani, Cristina
Allievi, Niccolò
Giulii Capponi, Michela
author_facet Calcagno, Pietro
Lotti, Marco
Campanati, Luca
Greco, Salvatore
Trezzi, Rosangela
Assolari, Andrea
Vaterlini, Elisa
Bertani, Cristina
Allievi, Niccolò
Giulii Capponi, Michela
author_sort Calcagno, Pietro
collection PubMed
description Ectopic pancreas is a rare embryological abnormality apparently not in association with others. Stomach and duodenum are the most common organs involved. Symptoms are nonspecific. Patients may complain of dyspepsia, abdominal pain or intestinal obstruction. Malignant evolution of ectopic pancreatic cells has been reported. Diagnosis can be very challenging due to the rarity of the disease and the absence of specific symptoms and radiological findings. We report two cases of young-adult men admitted to the emergency department due to acute upper gastro-intestinal and pancreatic symptoms. In both cases, during upper gastrointestinal endoscopy no mucosal vegetations were found. Endoscopic ultrasonography revealed gastric lesions originating from the muscularis propria, with a pattern suspected but not conclusive for malignancy. Fine needle aspiration was inconclusive in both cases. The patients underwent abdominal computed tomography, that showed gastric masses originating from the antrum and the lesser curvature of the stomach, with enlarged locoregional lymph nodes. According to the patients’ symptoms, family history, radiological and cytological findings, the patients were scheduled for an explorative laparoscopy. In both cases, gastric ectopic pancreas was found. Clinical presentation of ectopic pancreas is heterogeneous and the diagnosis can be challenging, especially in an emergency setting. Endoscopic ultrasonography and fine needle aspiration can be useful for the diagnosis and clinical staging, but they can be unspecific. Diagnostic-therapeutic laparoscopy should be considered in symptomatic patients.
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spelling pubmed-63250262019-01-15 Emergency Presentation of Gastric Ectopic Pancreas Calcagno, Pietro Lotti, Marco Campanati, Luca Greco, Salvatore Trezzi, Rosangela Assolari, Andrea Vaterlini, Elisa Bertani, Cristina Allievi, Niccolò Giulii Capponi, Michela Cureus Emergency Medicine Ectopic pancreas is a rare embryological abnormality apparently not in association with others. Stomach and duodenum are the most common organs involved. Symptoms are nonspecific. Patients may complain of dyspepsia, abdominal pain or intestinal obstruction. Malignant evolution of ectopic pancreatic cells has been reported. Diagnosis can be very challenging due to the rarity of the disease and the absence of specific symptoms and radiological findings. We report two cases of young-adult men admitted to the emergency department due to acute upper gastro-intestinal and pancreatic symptoms. In both cases, during upper gastrointestinal endoscopy no mucosal vegetations were found. Endoscopic ultrasonography revealed gastric lesions originating from the muscularis propria, with a pattern suspected but not conclusive for malignancy. Fine needle aspiration was inconclusive in both cases. The patients underwent abdominal computed tomography, that showed gastric masses originating from the antrum and the lesser curvature of the stomach, with enlarged locoregional lymph nodes. According to the patients’ symptoms, family history, radiological and cytological findings, the patients were scheduled for an explorative laparoscopy. In both cases, gastric ectopic pancreas was found. Clinical presentation of ectopic pancreas is heterogeneous and the diagnosis can be challenging, especially in an emergency setting. Endoscopic ultrasonography and fine needle aspiration can be useful for the diagnosis and clinical staging, but they can be unspecific. Diagnostic-therapeutic laparoscopy should be considered in symptomatic patients. Cureus 2018-11-08 /pmc/articles/PMC6325026/ /pubmed/30648097 http://dx.doi.org/10.7759/cureus.3565 Text en Copyright © 2018, Calcagno et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Calcagno, Pietro
Lotti, Marco
Campanati, Luca
Greco, Salvatore
Trezzi, Rosangela
Assolari, Andrea
Vaterlini, Elisa
Bertani, Cristina
Allievi, Niccolò
Giulii Capponi, Michela
Emergency Presentation of Gastric Ectopic Pancreas
title Emergency Presentation of Gastric Ectopic Pancreas
title_full Emergency Presentation of Gastric Ectopic Pancreas
title_fullStr Emergency Presentation of Gastric Ectopic Pancreas
title_full_unstemmed Emergency Presentation of Gastric Ectopic Pancreas
title_short Emergency Presentation of Gastric Ectopic Pancreas
title_sort emergency presentation of gastric ectopic pancreas
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6325026/
https://www.ncbi.nlm.nih.gov/pubmed/30648097
http://dx.doi.org/10.7759/cureus.3565
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