Changing pattern of ectopic pancreas: 22 years of experience in a medical center

Abstract

Background/purpose: Ectopic pancreas is usually a silent gastrointestinal malformation. It may become clinically evident when complicated by chronic inflammation or by growth. More ileal ectopic pancreas has been found in recent years in our hospital. We report the clinical manifestation of ectopic pancreas over the past 22 years.

Methods: We reviewed the medical records of patients seen between May 1984 and December 2005 at Mackay Memorial Hospital, with a diagnosis of ectopic pancreas, and extracted clinical and histopathology data from the records.

Results: A total of 39 patients (18 male, 21 female; mean age, 46 years) were diagnosed with ectopic pancreas. Most patients were aged between 30 and 50 years. Only 15 (38%) had symptoms suggestive of ectopic pancreas. These included abdominal pain (n = 9), upper gastrointestinal bleeding (n = 5), and abdominal distension (n = 2). The diagnosis in the other 24 patients was made incidentally, usually during surgery for other conditions. While lesions in the stomach were more likely to be diagnosed because of symptoms (12 of 13), lesions in the small bowel were almost always diagnosed incidentally. Only one of eight in the duodenum, one of 10 in the jejunum, and one of eight in the ileum, were isolated findings. One case of ectopic pancreas was detected by capsule endoscopy.

Conclusion: Ectopic pancreas can be found in various parts of the gastrointestinal tract. The high proportion of ileal ectopic pancreas is unexpected and needs further study.