Department of General Surgery, Nanto Municipal Hospital, 938 Inami, Nanto City, Toyama, 932-0211, Japan.
Clin J Gastroenterol. 2020 Jun;13(3):465-471. doi: 10.1007/s12328-019-01073-8. Epub 2019 Nov 23.
Ectopic pancreas is a congenital developmental anomaly that may be caused by embryologic errors. The pathogenetic details of ectopic pancreas remain unclear, but it has gradually been determined to originate at the gene level. DNA errors during embryological development cause ectopic pancreas. Ectopic pancreas is generally asymptomatic and harmless throughout the patient's entire life; in very rare cases, however, it can be symptomatic and harmful, causing pain, fever, bleeding, and other adverse effects. We herein report an unusual case involving a 52-year-old Japanese woman who presented with nausea and vomiting due to inflammation of an ectopic pancreas in the gastric antrum. Ectopic pancreatitis caused severe pyloric stenosis, and she was unable to ingest food or water even after admission to the internal medicine ward. Ectopic pancreatitis is a very rare clinical condition, but clinicians should be cautious of this uncommon disease in patients who develop gastric outlet obstruction without cancer or ulcers. The present case report is clinically significant because surgical treatment (distal partial gastrectomy) relieved the patient's serious distress rapidly and successfully after unsuccessful conservative treatments for acute ectopic pancreatitis. Antrectomy (distal partial gastrectomy) might be useful for ectopic pancreas, especially in case of gastric outlet obstruction due to the ectopic pancreatitis.
胰腺异位是一种先天性发育异常，可能由胚胎发育错误引起。胰腺异位的确切发病机制尚不清楚，但逐渐确定其起源于基因水平。胚胎发育过程中的 DNA 错误导致胰腺异位。胰腺异位在患者整个生命周期内通常无症状且无害；然而，在极少数情况下，它可能会出现症状并造成伤害，引起疼痛、发热、出血等不良反应。本文报告了一例不常见的病例，涉及一名 52 岁的日本女性，因胃窦异位胰腺炎症而出现恶心和呕吐。异位性胰腺炎导致严重的幽门狭窄，即使在内科病房住院后，她也无法进食或饮水。异位性胰腺炎是一种非常罕见的临床情况，但对于因癌症或溃疡以外的原因发生胃出口梗阻的患者，临床医生应警惕这种不常见的疾病。本病例报告具有重要的临床意义，因为在急性异位性胰腺炎的保守治疗无效后，手术治疗（远端部分胃切除术）迅速成功地缓解了患者的严重痛苦。对于异位性胰腺炎，尤其是由于异位性胰腺炎引起的胃出口梗阻，进行胃切除术（远端部分胃切除术）可能是有用的。
