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  • Title: Heterotopic pancreatitis: gastric outlet obstruction due to an intramural pseudocyst and hamartoma.
    Author: Eisenberger CF, Kropp A, Langwieler TE, Gocht A, Izbicki JR, Knoefel WT.
    Journal: Z Gastroenterol; 2002 Apr; 40(4):259-62. PubMed ID: 11961736.
    Abstract:
    Heterotopic pancreas, usually a silent gastrointestinal malformation, may become clinically evident when complicated by chronic inflammation. We report a case of pancreatitis and extensive pseudocyst formation in the gastric antrum, which caused gastric outlet obstruction. The diagnosis was obscured by a history of emesis during pregnancy and a previously resected gastric polyp. The nature of the obstructive lesion was not diagnosed preoperatively in spite of endosonographic evaluation. Intraoperatively, a cystic tumor of the stomach wall was found, the lesion was excised, and a pyloroplasty was performed to close the excision site. Histology revealed heterotopic pancreatic tissue with chronic inflammation, fibrosis and pseudocyst formation and adjacent to this lesion a myoglandular hamartoma. The patient is symptom-free two years after surgery and no recurrence was found. The nature of heterotopic pancreatic tissue, its diagnosis and management are discussed.
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