Diagnosis and treatment of gastric heterotopic pancreas

Abstract

Background: Heterotopic pancreas (HP) in the stomach can be difficult to diagnose and there are many treatment options. The aim of this article is to review the contemporary diagnosis of and treatment options for HP in the stomach.

Methods: We undertook a retrospective review of patients with the diagnosis heterotopic pancreas registered at St. Olavs University Hospital in Trondheim from 1990 to 2002. We report on clinical findings, provide a histological review, and summarize the literature with particular emphasis on the diagnosis and treatment of HP in the stomach.

Results: We found 32 cases, most of them in the stomach and the small intestine. Sixteen patients were symptomatic. A histological examination showed that most of the tumors were submucosal and had the appearance of normal pancreas tissue.

Conclusion: Gastric HP is not an uncommon diagnosis compared with many other gastric tumors and should more often be considered as a differential diagnosis. Symptom correlation is not always easy to determine, but symptom relief after treatment is well established. An endoscopic ultrasound examination may help when screening patients for extended biopsy and in deciding on which type of operation is to be performed. When treated, minimally invasive techniques should be applied.