Chou Shao-Jiun, Chou Yu-Wei, Jan Hsiang-Chun, Chen Victor T K, Chen Tzu-Hung
Division of General Surgery, Department of Surgery, Cardinal Tien Hospital, College of Medicine, Fu Jen Catholic University, 362 Chung Cheng Road, Hsintien Taipei Hsien 23237, Taiwan/ROC.
Dig Surg. 2006;23(4):262-4. doi: 10.1159/000096158. Epub 2006 Oct 10.
Ectopic pancreas is an uncommon condition and is usually found in the gastrointestinal tract, such as stomach, duodenum and jejunum. However, ectopic pancreas in the ampulla of Vater is rare and its clinical presentations may be similar to periampullary cancer. It is difficult to diagnose preoperatively. We present such a case where the diagnosis was proven postoperatively. Our patient, a 51-year-old man, presented with epigastric pain, jaundice, weight loss and abnormal laboratory data. Imaging study, including abdominal sonography, abdominal computerized tomography with contrast and endoscopic retrograde cholangiopancreatography, showed a mass protruding into the ampulla of Vater. The mass was resected and histological examination revealed an ectopic pancreas. The patient presented with symptoms of periampullary tumor but the imaging study did not reveal an obvious lesion for us consider the possibility of ectopic pancreas. Surgical excision is indicated for symptomatic cases.
异位胰腺是一种罕见的病症，通常见于胃肠道，如胃、十二指肠和空肠。然而，位于Vater壶腹的异位胰腺极为罕见，其临床表现可能与壶腹周围癌相似。术前诊断困难。我们在此呈现一例术后确诊的病例。我们的患者是一名51岁男性，表现为上腹部疼痛、黄疸、体重减轻及实验室检查数据异常。影像学检查，包括腹部超声、腹部增强计算机断层扫描及内镜逆行胰胆管造影，显示有一肿物突入Vater壶腹。该肿物被切除，组织学检查显示为异位胰腺。患者表现出壶腹周围肿瘤的症状，但影像学检查未发现明显病变，使我们未考虑异位胰腺的可能性。有症状的病例需行手术切除。
