Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
권호 표지

Partial gastric outlet obstruction caused by a huge submucosal tumor originating in the heterotopic pancreas

  • Jung, Gum-O (Department of Surgery, Wonkwang University Hospital, Wonkwang University of College of Medicine) ;
  • Park, Dong-Eun (Department of Surgery, Wonkwang University Hospital, Wonkwang University of College of Medicine) ;
  • Yun, Ki-Jung (Department of Pathology, Wonkwang University Hospital, Wonkwang University of College of Medicine) ;
  • Chae, Kwon-Mook (Department of Surgery, Wonkwang University Hospital, Wonkwang University of College of Medicine)
  • Published : 2011.08.31
⟨ Previous Next ⟩

Abstract

A 21-year-old woman presented gastrointestinal manifestation showing intermittent abdominal pain, nausea, and vomiting. An upper endoscopic examination showed round, elevated mucosa at the antrum of the stomach anterior wall. After CT scanning, a huge degenerated gastrointestinal stromal tumor was suspected. Subtotal gastrectomy with Billroth II anastomosis was performed. Histologically, pseudocystic degeneration of the heterotopic pancreas was confirmed. The patient showed eventful postoperative course except temporary dilated gastric emptying. The patient is doing well without any abnormal symptom at 8-month follow-up. This report is a rare case of gastric outlet obstruction caused by a pseudocyst originating from a heterotopic pancreas in the gastric antrum.

Keywords

References

  1. Jaffee R. The pancreas. In: Wigglesworth JS, Singer DB, eds. Textbook of fetal and perinatal pathology. Vol 2nd ed. Boston, Massachusetts; Blackwell Scientific, 1991:1021-1055.
  2. Mizuno Y, Sumi Y, Nachi S, et al. Acinar cell carcinoma arising from an ectopic pancreas. Surg Today 2007;37:704-707. https://doi.org/10.1007/s00595-006-3384-5
  3. Mulholland KC, Wallace WD, Epanomeritakis E, Hall SR. Pseudocyst formation in gastric ectopic pancreas. JOP 2004;5:498-501.
  4. Tolentino LF, Lee H, Maung T, Stabile BE, Li K, French SW. Islet cell tumor arising from a heterotopic pancreas in the duodenal wall with ulceration. Exp Mol Pathol 2004;76:51-56. https://doi.org/10.1016/j.yexmp.2003.08.005
  5. Kaneda M, Yano T, Yamamoto T, et al. Ectopic pancreas in the stomach presenting as an inflammatory abdominal mass. Am J Gastroenterol 1989;84:663-666.
  6. Dolan RV, ReMine WH, Dockerty MB. The fate of heterotopic pancreatic tissue. A study of 212 cases. Arch Surg 1974;109:762-765. https://doi.org/10.1001/archsurg.1974.01360060032010
  7. Song DE, Kwon Y, Kim KR, Oh ST, Kim JS. Adenocarcinoma arising in gastric heterotopic pancreas: a case report. J Korean Med Sci 2004;19:145-148. https://doi.org/10.3346/jkms.2004.19.1.145
  8. Heinrich H. Ein beitrag zur histologie des sogen, akzessorichen pankreas Virchows Arch Path Anat 1909;198:392-401. https://doi.org/10.1007/BF02085327
  9. Hsia CY, Wu CW, Lui WY. Heterotopic pancreas: a difficult diagnosis. J Clin Gastroenterol 1999;28:144-147. https://doi.org/10.1097/00004836-199903000-00012
  10. Cho JS, Shin KS, Kwon ST, et al. Heterotopic pancreas in the stomach: CT findings. Radiology 2000;217:139-144.
  11. Cuschieri A. Laparoscopic gastric resection. Surg Clin North Am 2000;80:1269-1284. https://doi.org/10.1016/S0039-6109(05)70224-3