Xu Yaying Eileen, Hendahewa Rasika
General Surgical Department, Caboolture Hospital, Caboolture, Queensland 4510, Australia.
J Surg Case Rep. 2020 Feb 12;2020(2):rjz395. doi: 10.1093/jscr/rjz395. eCollection 2020 Feb.
Heterotopic pancreas (HP) is a rare condition, is commonly asymptomatic and found incidentally at autopsy or during abdominal surgery. HP is usually found in the upper gastrointestinal tract, particularly in the stomach, duodenum and jejunum. Mesenteric heterotopic pancreas (MHP) has been rarely described in the literature, and there has been no reported case under ten years of age. We report a unique case of a 7-year-old African boy who presented with clinical appendicitis and intraoperatively was found to have a necrotic nodular mass in the jejunal mesentery which required segmental small bowel resection. Histology revealed mesenteric heterotopic pancreas with normal pancreatic tissue. As pre-operative diagnosis of MHP is difficult; we encourage a heightened awareness of this condition as a differential diagnosis in children presenting with abdominal pain and an inflammatory mass, which will subsequently aid in the management of these patients.
异位胰腺(HP)是一种罕见病症,通常无症状,多在尸检或腹部手术时偶然发现。HP 通常见于上消化道,尤其是胃、十二指肠和空肠。肠系膜异位胰腺(MHP)在文献中鲜有描述,且尚无 10 岁以下的病例报道。我们报告了一例独特的病例,一名 7 岁非洲男孩,临床表现为阑尾炎,术中发现空肠系膜有一个坏死性结节状肿块,需要进行小肠节段性切除。组织学检查显示为肠系膜异位胰腺,伴有正常胰腺组织。由于 MHP 的术前诊断困难,我们鼓励提高对这种病症的认识,将其作为腹痛和炎性肿块患儿的鉴别诊断,这将有助于后续对这些患者的管理。