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Gastric outlet obstruction secondary to heterotopic pancreas being mistaken for gastric cancer: “Case report”

INTRODUCTION: Heterotopic pancreas (HP) is an uncommon and often incidental finding in clinical practice. It is the presence of pancreatic tissue distinct from the normal pancreas and with its own ductal and vascular supply. Distal stomach is the most common location of heterotopic pancreas followed...

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Autor principal: Bejiga, Gosa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8980623/
https://www.ncbi.nlm.nih.gov/pubmed/35367947
http://dx.doi.org/10.1016/j.ijscr.2022.106974
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author Bejiga, Gosa
author_facet Bejiga, Gosa
author_sort Bejiga, Gosa
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description INTRODUCTION: Heterotopic pancreas (HP) is an uncommon and often incidental finding in clinical practice. It is the presence of pancreatic tissue distinct from the normal pancreas and with its own ductal and vascular supply. Distal stomach is the most common location of heterotopic pancreas followed by duodenum and jejunum. Most patients with heterotopic pancreas are asymptomatic. Gastric outlet obstruction is a rare presentation of heterotopic pancreas that can follow chronic inflammation and fibrosis of the pylorus from pancreatic secretion, pancreatitis, or malignant transformation. Heterotopic pancreas can be confused for gastric carcinomas on CECT and endoscopy. The aim of this paper is to present a rare case of gastric outlet obstruction due to heterotopic pancreas, mistaken for gastric cancer on endoscopy and CT scan, and its management. PRESENTATION OF THE CASE: A 45 years old male from Adama, Ethiopia presented with vomiting of 8 months, which worsened since the last one month. He has no history of smoking and diabetes. He occasionally drinks alcohol. Physical examination was normal. CECT scan and endoscopy suggested distal gastric cancer. Radical subtotal gastrectomy done as gastric cancer couldn't be ruled out with excellent outcome. Histopathology revealed obstructing prepyloric chronic fibrosis and heterotopic pancreas. DISCUSSION: Heterotopic pancreas is a rare pathological entity, clinical diagnosis is difficult preoperatively and frequently an incidental finding at laparotomy. CONCLUSION: Though rare, heterotopic pancreas can present with gastric outlet obstruction and cause diagnostic confusion with gastric cancer. Definitive diagnosis is by histology that can also guide limited resection intraoperatively.
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spelling pubmed-89806232022-04-06 Gastric outlet obstruction secondary to heterotopic pancreas being mistaken for gastric cancer: “Case report” Bejiga, Gosa Int J Surg Case Rep Case Report INTRODUCTION: Heterotopic pancreas (HP) is an uncommon and often incidental finding in clinical practice. It is the presence of pancreatic tissue distinct from the normal pancreas and with its own ductal and vascular supply. Distal stomach is the most common location of heterotopic pancreas followed by duodenum and jejunum. Most patients with heterotopic pancreas are asymptomatic. Gastric outlet obstruction is a rare presentation of heterotopic pancreas that can follow chronic inflammation and fibrosis of the pylorus from pancreatic secretion, pancreatitis, or malignant transformation. Heterotopic pancreas can be confused for gastric carcinomas on CECT and endoscopy. The aim of this paper is to present a rare case of gastric outlet obstruction due to heterotopic pancreas, mistaken for gastric cancer on endoscopy and CT scan, and its management. PRESENTATION OF THE CASE: A 45 years old male from Adama, Ethiopia presented with vomiting of 8 months, which worsened since the last one month. He has no history of smoking and diabetes. He occasionally drinks alcohol. Physical examination was normal. CECT scan and endoscopy suggested distal gastric cancer. Radical subtotal gastrectomy done as gastric cancer couldn't be ruled out with excellent outcome. Histopathology revealed obstructing prepyloric chronic fibrosis and heterotopic pancreas. DISCUSSION: Heterotopic pancreas is a rare pathological entity, clinical diagnosis is difficult preoperatively and frequently an incidental finding at laparotomy. CONCLUSION: Though rare, heterotopic pancreas can present with gastric outlet obstruction and cause diagnostic confusion with gastric cancer. Definitive diagnosis is by histology that can also guide limited resection intraoperatively. Elsevier 2022-03-29 /pmc/articles/PMC8980623/ /pubmed/35367947 http://dx.doi.org/10.1016/j.ijscr.2022.106974 Text en © 2022 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Bejiga, Gosa
Gastric outlet obstruction secondary to heterotopic pancreas being mistaken for gastric cancer: “Case report”
title Gastric outlet obstruction secondary to heterotopic pancreas being mistaken for gastric cancer: “Case report”
title_full Gastric outlet obstruction secondary to heterotopic pancreas being mistaken for gastric cancer: “Case report”
title_fullStr Gastric outlet obstruction secondary to heterotopic pancreas being mistaken for gastric cancer: “Case report”
title_full_unstemmed Gastric outlet obstruction secondary to heterotopic pancreas being mistaken for gastric cancer: “Case report”
title_short Gastric outlet obstruction secondary to heterotopic pancreas being mistaken for gastric cancer: “Case report”
title_sort gastric outlet obstruction secondary to heterotopic pancreas being mistaken for gastric cancer: “case report”
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8980623/
https://www.ncbi.nlm.nih.gov/pubmed/35367947
http://dx.doi.org/10.1016/j.ijscr.2022.106974
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