Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2014 Sep;17(3):196-200.
doi: 10.5223/pghn.2014.17.3.196. Epub 2014 Sep 30.

How should the pyloric submucosal mass coexisting with hypertrophic pyloric stenosis be treated?: a case of pyloric ectopic pancreas with hypertrophic pyloric stenosis

Soo-Hong Kim  1 , Tae-Kyung Yoo  2 , Hyun-Young Kim  2 , Sung-Eun Jung  2 , Kwi-Won Park  2
Affiliations
Case Reports

How should the pyloric submucosal mass coexisting with hypertrophic pyloric stenosis be treated?: a case of pyloric ectopic pancreas with hypertrophic pyloric stenosis

Soo-Hong Kim et al. Pediatr Gastroenterol Hepatol Nutr. 2014 Sep.

Abstract

Co-existing pyloric submucosal masses with hypertrophic pyloric stenosis (HPS) are very rare and treating these lesions is always a problem. A 20-day-old boy presented with recurrent episodes of projectile non-bilious vomiting lasting for 5 days. HPS was suspected due to the presenting age and the symptoms. The sonography demonstrated not only circumferential wall thickening of the pylorus, but also a pyloric submucosal mass. At laparotomy, a 0.8 cm sized pyloric submucosal mass was identified along with a hypertrophied pylorus. Pyloric excision was performed due to the possibility of sustaining the symptoms and malignancy. The pathological report of the submucosal mass was ectopic pancreas. Coexisting pyloric lesions can be diagnosed along with HPS, and surgical excision, not just pyloromyotomy, should be considered in these circumstances. To the best of our knowledge, this is the first case report of pyloric ectopic pancreas and HPS to be diagnosed concurrently.

Keywords: Ectopic pancreas; Gastric submucosal mass; Hypertrophic; Infant; Pyloric stenosis.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Abdomen ultrasonography. (A) 0.8×0.7×0.4 cm intramural cystic lesion at the anterior wall of the pylorus (arrow). (B) Hypertrophied pyloric muscle (arrow).
Fig. 2
Fig. 2
Fluoroscopic upper gastrointestinal contrast study. Narrowing and shouldering at the pylorus (arrows) consistent with hypertrophic pyloric stenosis.
Fig. 3
Fig. 3
Magnetic resonance imaging. T2 bright signal intensity and non-enhancing submucosal cystic lesion at the lateral wall of the pylorus (arrows).
Fig. 4
Fig. 4
Gross finding. Submucosal pyloric mass.
Fig. 5
Fig. 5
Microscopic finding. Hypertrophied outer proper muscle (arrows) with heterotopic pancreas (arrowheads) (H&E, ×200).
See this image and copyright information in PMC

References

    1. Chin AC, Radhakrishnan RS, Lloyd J, Reynolds M. Pyloric duplication with communication to the pancreas in a neonate simulating hypertrophic pyloric stenosis. J Pediatr Surg. 2011;46:1442–1444. - PubMed
    1. Takeyama J, Sato T, Tanaka H, Nio M. Adenomyoma of the stomach mimicking infantile hypertrophic pyloric stenosis. J Pediatr Surg. 2007;42:E11–E12. - PubMed
    1. Ozcan C, Celik A, Güçlü C, Balik E. A rare cause of gastric outlet obstruction in the newborn: Pyloric ectopic pancreas. J Pediatr Surg. 2002;37:119–120. - PubMed
    1. Hishiki T, Saito T, Terui K, Mitsunaga T, Nakata M, Matsuura G, et al. A rare presentation in a case of gastric duplication cyst communicating to the pancreatic duct: coincidental detection during pyloromyotomy for hypertrophic pyloric stenosis. J Pediatr Surg. 2008;43:e1–e3. - PubMed
    1. Kim S, Chung CJ, Fordham LA, Specter BB. Coexisting hyperplastic antral polyp and hypertrophic pyloric stenosis. Pediatr Radiol. 1997;27:912–914. - PubMed

Publication types