Alqahtani Awadh, Aljohani Emad, Almadi Fahad, Billa Srikar, Alqahtani Mohammad, Alkhaldi Hisham
King Saud University, Riyadh, Saudi Arabia.
Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-kharj, Saudi Arabia.
Int J Surg Case Rep. 2020;67:39-41. doi: 10.1016/j.ijscr.2019.12.040. Epub 2020 Jan 9.
Heterotopic pancreas, also known as ectopic pancreas, is defined as the presence of pancreatic tissue outside its normal location and without anatomic and vascular continuity with the main body of the pancreas. The incidence of heterotopic pancreas has been reported as 0.5 % during laparotomies and at autopsy ranging from 0.6-14 %.
A 28 years old obese male, medically free electively admitted for laparoscopic sleeve gastrectomy. Intraoperatively after dissecting the greater omentum from the stomach and inserting the 36 Fr gastric bougie, small oval shape mass about 1 cm close to the lesser curvature on the anterior surface of the gastric antrum. Macroscopically benign looking and a thorough laparoscopic exploration showed no signs of other organs involvement. Antrectomy and mini gastric bypass done. The postoperative course was uneventful. The histopathological examination of the antrectomy specimen showed heterotopic pancreas in the subserosa of gastric antrum.
The Heterotopic pancreatic tissue can be discovered in the stomach (particularly antrum), duodenum, jejunum, or a Meckel diverticulum. Surgical resection is the mainstay treatment if the heterotopic pancreas is symptomatic or when the lesion is found incidentally during surgery in order to prevent complications.
Heterotopic pancreas should always be considered in the differential diagnosis of incidentally found gastric lesions and can be safely resected. This is the first case report of gastric heterotopic pancreas which is found incidentally during a bariatric surgery procedure.
异位胰腺，也称为迷走胰腺，定义为胰腺组织存在于其正常位置之外，且与胰腺主体无解剖和血管连续性。据报道，在剖腹手术中异位胰腺的发生率为0.5%，尸检时为0.6%-14%。
一名28岁肥胖男性，因择期接受腹腔镜袖状胃切除术而入院。术中在将大网膜从胃部分离并插入36 Fr胃探条后，在胃窦前表面靠近小弯处发现一个约1厘米的小椭圆形肿块。肉眼看起来为良性，全面的腹腔镜探查未发现其他器官受累迹象。进行了胃窦切除术和迷你胃旁路手术。术后过程顺利。胃窦切除标本的组织病理学检查显示胃窦浆膜下层存在异位胰腺。
异位胰腺组织可在胃（尤其是胃窦）、十二指肠、空肠或梅克尔憩室中发现。如果异位胰腺有症状，或者在手术中偶然发现病变以预防并发症，手术切除是主要治疗方法。
在偶然发现的胃部病变的鉴别诊断中应始终考虑异位胰腺，并且可以安全地进行切除。这是第一例在减肥手术过程中偶然发现的胃异位胰腺病例报告。
