Heterotopic Pancreas
Heterotopic Pancreas

Video Endoscopic Sequence 1 of 6.

Heterotopic Pancreas with large Central Hole.

Heterotopic Pancreas, due to the hole, as the diameter is not usual in the heterotopic pancreas, some biopsies were obtained from the submucosa which histologically demostrated pancreatic tissue.

Heterotopic pancreatic tissue, also termed a “pancreatic rest,” can be found in the stomach, duodenum, or jejunum. Typically, these rests are asymptomatic, but abdominal pain, nausea, vomiting, and rarely bleeding have been attributed to rests located in the stomach. These lesions typically appear as 2- to 4-cm submucosal masses in the prepyloric region, and it is not unusual that central umbilication is noted. The nodules are firm and may have a yellow appearance. Endoscopic ultrasound will show a heterogenous submucosal mass with a pancreatic duct remnant.

For more endoscopic details download the video clips by clicking on the endoscopic images, wait to be downloaded complete then press Alt and Enter; thus you can observe the video in full screen.

All endoscopic images shown in this Atlas contain
video clips.

 

Heterotopic Pancreas

Video Endoscopic Sequence 2 of 6.

Heterotopic pancreas is an uncommon but not an
exceedingly rare finding. Most of the time, the heterotopic
pancreas is usually small (1 cm to 3 cm in size) and located
in the antrum. Pancreatic rests are often discovered
incidentally.

Despite the observation that most cases of heterotopic
pancreas do not cause problems, the condition has been
reported to lead to symptoms from inflammation,
obstruction, or even malignant transformation. Smaller
rests have been removed using endoscopic techniques,
primarily to secure a diagnosis, as the smaller tumors are
often asymptomatic.

 

Heterotopic Pancreas

Video Endoscopic Sequence 3 of 6.

The biopsies were obtain from the submucosa

Although malignant transformation has been reported, this
appears to be uncommon enough that recommendations on
follow up probably should be based on symptoms.

With the abuse of alcohol has been reported "gastric pancreatitis."

 

Heterotopic Pancreas

Video Endoscopic Sequence 4 of 6.

Low power view of gastric heterotopic pancreas.

 

Heterotopic Pancreas

Video Endoscopic Sequence 5 of 6.

Acinar pancratic tissue at the left.

 

Heterotopic Pancreas

Video Endoscopic Sequence 6 of 6.

High power detail of the heterotopic pancreas.

 

Heterotopic Pancreas

Heterotopic Pancreas

The majority of the patients are asymptomatic and the
lesion is diagnosed incidentally.

Heterotopic pancreas is defined as pancreatic tissue
outside the boundaries of the pancreas that lacks anatomic
and vascular continuity to this organ. Heterotopic pancreas
is a relatively infrequent lesion.

The pathogenesis of this lesion is unknown; it is believed to
arise during embryonic development of the gastrointestinal
tract. The normal pancreas is derived from several
evaginations originating from the wall of the primitive
duodenum. During embryogenesis, if one or more
evaginations remain in the wall of the bowel, then it maybe
carried away from the remainder of the gland by the
developing gastrointestinal tract and may give rise to
heterotopic pancreas.

 

Pancreatic Heterotopia.

Pancreatic Heterotopia.

Antral nodule with typically central depression and intact
overlying, antral mucosa, the submucosa is the most
frequent location, both exocrine and endocrine pancreatic
tissue may comprise the lesion.
The most distinctive heterotopic lesions occurs in the
antrum. 
Ectopic pancreas generally has a typical apical dimple
characteristic of this lesion. A rudimentary
ductal system may empty into this depression.

 

Heterotopic Pancreas

Video Endoscopic Sequence 1 of 3.

Heterotopic Pancreas and Follicular Lymphoid Hyperplasia

 

Heterotopic Pancreas

Video Endoscopic Sequence 2 of 3.

Endoscopic Image of Heterotopic Pancreas and Follicular
Lymphoid Hyperplasia.

 

Heterotopic Pancreas

Video Endoscopic Sequence 3 of 3.

Endoscopy of Heterotopic Pancreas and Follicular Lymphoid Hyperplasia.

 

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