Li Jiannan, Huang Haibin, Huo Sibo, Liu Ying, Xu Guangmeng, Gao Hongwen, Zhang Kai, Liu Tongjun
Department of General Surgery Department of Pathology, The Second Hospital of Jilin University, Changchun, Jilin, China.
Medicine (Baltimore). 2017 Sep;96(35):e7986. doi: 10.1097/MD.0000000000007986.
Ectopic pancreas, which is a kind of rare congenital disease, forms during embryonic development. It can occur throughout the whole gastrointestinal tract, but has a low tendency to develop in the wall of the small intestine. It is easy for patients with ectopic pancreases to be misdiagnosed because the symptoms are untypical and can vary.
In the present study, we reported two rare cases of ectopic pancreatic tissue in the wall of the small intestine, which presented with obvious abdominal pain and distention.
The laboratory tests and computed tomography (CT) scans didn't reveal any evidence of ectopic pancreas.
The two patients received small intestine masses resection and intestinal anastomosis.
During surgery, an intestinal mass with a diameter of 4.0 cm was found in the first patient. An intestinal mass with a diameter of 0.8 cm, jejunum perforation, and diffuse peritonitis were found in the second patient. Histological analyses of the dissected intestinal masses confirmed them as ectopic pancreatic tissue. Interestingly, for the second patient, the intestinal perforation and diffuse peritonitis were not induced by the ectopic pancreas, but by a jujube pit that was found in the perforated site of the intestine.
Our study demonstrated that an ectopic pancreas should be considered in cases of untypical abdominal symptoms with intestinal masses.
异位胰腺是一种罕见的先天性疾病，在胚胎发育过程中形成。它可发生于整个胃肠道，但在小肠壁中发生的倾向较低。异位胰腺患者容易被误诊，因为症状不典型且可能各异。
在本研究中，我们报告了两例罕见的小肠壁异位胰腺组织病例，表现为明显的腹痛和腹胀。
实验室检查和计算机断层扫描（CT）未发现异位胰腺的任何证据。
两名患者均接受了小肠肿物切除及肠吻合术。
手术中，在首例患者中发现一个直径4.0厘米的肠肿物。在第二例患者中发现一个直径0.8厘米的肠肿物、空肠穿孔及弥漫性腹膜炎。对切除的肠肿物进行组织学分析证实为异位胰腺组织。有趣的是，对于第二例患者，肠穿孔和弥漫性腹膜炎并非由异位胰腺引起，而是由在肠穿孔部位发现的一枚枣核所致。
我们的研究表明，对于有肠肿物且伴有非典型腹部症状的病例，应考虑异位胰腺的可能性。
