Two Cases of Heterotopic Pancreas of the Small Bowel Incidentally Found During Laparoscopic Bariatric Surgery

BACKGROUND: We present two cases of incidentally found heterotopic pancreas during laparoscopic bariatric surgery. Heterotopic pancreas is a rare congenital anomaly where pancreatic tissue is located outside of the pancreas. These lesions may be encountered incidentally during surgery, which raise unexpected management questions. CASE 1: A single pathology confirmed ectopic pancreas lesion encountered in the jejunem during laparoscopic Roux-en Y gastric bypass. CASE 2: Two pathology confirmed heterotopic pancreas lesions encountered in the jejunem during laparoscopic Roux-en Y gastric bypass. DISCUSSION: Heterotopic pancreas lesions are generally benign and encountered incidentally during intra-abdominal surgery. Surgeons must decide whether to resect the incidentally found mass. When encountered intraoperatively, a heterotopic pancreas lesion found in the small bowel without concerning features should be considered benign and does not warrant resection or biopsy.