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Case Reports
. 2023 Feb 10;10(2):e00988.
doi: 10.14309/crj.0000000000000988. eCollection 2023 Feb.

Gastric Ectopic Pancreas With Pseudocyst Formation Causing Gastric Outlet Obstruction

Austin Dickerson  1 , Aran Farrell  1 , Abida Bushra  2 , Scott Celinski  3 , Vani J A Konda  4 , Hemangi Kale  4 , Anh D Nguyen  4
Affiliations
Case Reports

Gastric Ectopic Pancreas With Pseudocyst Formation Causing Gastric Outlet Obstruction

Austin Dickerson et al. ACG Case Rep J. .

Abstract

Ectopic pancreas is a rare entity referring to the presence of pancreatic tissue at an anatomic location distinct from the pancreas. Ectopic pancreatic lesions in the stomach present a diagnostic challenge because the lack of distinguishing imaging and endoscopic features make them difficult to differentiate from other types of submucosal lesions. We report a case of ectopic pancreas presenting as a gastric antral mass with a unique combination of rare complications: chronic pancreatitis and pseudocyst formation causing gastric outlet obstruction. This case highlights complications that can occur from ectopic pancreatic lesions and the challenges of diagnosing ectopic pancreas.

Keywords: ectopic pancreas; gastric outlet obstruction; heterotopic pancreas; pancreatic pseudocyst; pancreatic rest.

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Figures

Figure 1.
Figure 1.
Abdominal and pelvic computed tomography from (A) initial presentation, showing a multiloculated cystic mass (noted by arrows) and thickening of the gastric antral wall. (B) Preoperative imaging 10 weeks later showing progression of the mass with 2 distinct cystic components (noted by arrows), gastric wall edema, and evidence of mass effect with a distended, fluid-filled stomach indicating gastric outlet obstruction.
Figure 2.
Figure 2.
Esophagogastroduodenoscopy (EGD) images from (A) index EGD demonstrating extrinsic compression at the gastric antrum. (B) Repeat EGD 1 month later showing progression of the submucosal mass with circumferential involvement of the antrum.
Figure 3.
Figure 3.
Endoscopic ultrasound image showing subepithelial multicystic lesion with an irregular border, which was sampled with fine-needle aspiration.
Figure 4.
Figure 4.
(A, B) Representative hematoxylin and eosin histology sections showing heterotopic pancreatic tissue in the stomach. (A) 4× and (B) 10× arrows denote pancreatic ducts and acini, and asterisks denote pancreatic islets. (C, D) Representative hematoxylin and eosin histology sections showing pseudocyst without any lining epithelium and inflammatory granulation tissue. (C) 4× and (D) 10× arrows denote the pseudocyst border devoid of an epithelial layer.
See this image and copyright information in PMC

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