Ectopic Pancreas in the Ampulla of Vater with Obstructive Jaundice
A Case Report and Review of LiteratureChou S.-J.a, b · Chou Y.-W.a · Jan H.-C.a, b · Chen V.T.K.a, b · Chen T.-H.a, b
aDivision of General Surgery, Department of Surgery, Cardinal Tien Hospital, College of Medicine, Fu Jen Catholic University, and bTri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan/ROC
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
Article / Publication Details
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.
© 2006 S. Karger AG, Basel
Barbosa JJ de C, Dockerty MB, Waugh JM: Pancreatic heterotopia: review of the literature and report of 41 authenticated surgical cases of which 25 were clinically significant. Surg Gynecol Obstet 1946;82:527–542.
- Kaneda M, Yano T, Yamamoto T, Suzuki T, Fugimori K, Itoh H, Mizumoto R: Ectopic pancreas in the stomach presenting as an inflammatory abdominal mass. Am J Gastroenterol 1989;84:663–666.
- Chen CH, Yang CC, Yeh YH, Chou DA, Kuo CL: Ectopic pancreas located in the major duodenal papilla: case report and review. Gastrointest Endosc 2001;53:121–123.
Hoelzer H: An occlusion of Vater’s ampulla by accessory pancreas. Zentralbl Chir 1940;67:1715–1717.
Varay A: Microscopic epithelioma of Vater’s ampulla. Paris Méd 1946;1:183–186.
Pearson S: Aberrant pancreas. Review of the literature and report of three cases, one of which produced common and pancreatic duct obstruction. Arch Surg 1951;63:168–184.
- Weber CM, Zito PF, Becker SM: Heterotopic pancreas: an unusual cause of obstruction of the common bile duct. Am J Gastroenterol 1968;49:153–159.
- Laughlin EH, Keown ME, Jackson JE: Heterotopic pancreas obstructing the ampulla of Vater. Arch Surg 1983;118:979–980.
Kubota K, Bandai Y, Watanabe M, et al: Biliary stricture due to mucosal hyperplasia of the common bile duct: a case report. Hepatogastroenterology 1996;43:14.
- Armstrong CP, King PM, Dixon JM, Macleod IB: The clinical significance of heterotopic pancreas in the gastrointestinal tract. Br J Surg 1981;68:384–387.
- Dolan RV, Remine WH, Dockerty MB: The fate of heterotopic pancreatic tissue: a study of 212 cases. Arch Surg 1974;109:762–765.
- Matsushita M, Hajiro K, Okazaki K, Takakuwa H: Gastric aberrant pancreas: EUS analysis in comparison with the histology. Gastrointest Endosc 1999;49:493–497.
- Hayes-Jordan A, Idowu O, Cohen R: Ectopic pancreas as the cause of gastric outlet obstruction in a newborn. Pediatr Radiol 1998;28:868–870.
- Gaspar Fuentes A, Campos Tarrech JM, Fernandez Burgui J: Ectopias pancreaticas. Rev Esp Enferm Apar Dig 1973;39:255–268.
- Tanaka K, Tsunoda T, Eto T, Yamada M, Jajima Y, Shimogama H, et al: Diagnosis and management of heterotopic pancreas. Int Surg 1993;78:32–35.
- Jochimsen PR, Shirazi SS, Lewis JW: Symptomatic ectopic pancreas relieved by surgical excision. Surg Gynecol Obstet 1981;153:49–52.
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.