Saudi Journal of Gastroenterology
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LETTER TO THE EDITOR Table of Contents   
Year : 2010  |  Volume : 16  |  Issue : 3  |  Page : 228
Ectopic pancreatic tissue in the cecum


1 Department of Surgery, Pramukhswami Medical College, Karamsad-388 325, Gujarat, India
2 Department of Pathology, Pramukhswami Medical College, Karamsad-388 325, Gujarat, India

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Date of Web Publication7-Jul-2010
 

How to cite this article:
Yagnik VD, Patel KB, Patel PA, Mulla FI. Ectopic pancreatic tissue in the cecum. Saudi J Gastroenterol 2010;16:228

How to cite this URL:
Yagnik VD, Patel KB, Patel PA, Mulla FI. Ectopic pancreatic tissue in the cecum. Saudi J Gastroenterol [serial online] 2010 [cited 2019 Dec 5];16:228. Available from: http://www.saudijgastro.com/text.asp?2010/16/3/228/65179


Sir,

A 58 years male was admitted to our hospital because of persistent right lower quadrant abdominal pain and melena. He had no history of a similar type of abdominal pain or melena. All blood investigations were normal. Skiagram and USG abdomen were also normal. Stool occult blood was positive. Colonoscopy revealed thickening and inflammation with ulceration in the cecum, no evidence of sub-mucosal nodule with central umbilication was seen [Figure 1]. HPE examination showed pancreatic acini and duct system. Each acinus is made up of irregular clusters of secreting cells. Intercalated ducts are lined by simple low cuboidal epithelium [Figure 2]. After initial medical management, the patient was symptom free. The patient refused surgery. To our knowledge, this is the first case of ectopic pancreatic tissue in the cecum.

Ectopic pancreatic tissue is common and functional. The frequency in autopsy has been reported from 0.55 to 13.7%. [1] The most common sites are the wall of the stomach, duodenum, followed by jejunum, Meckels, and ileum. [2] Most patients with ectopic pancreas are asymptomatic and are diagnosed at endoscopy, operation or autopsy, and, if present, symptoms are non-specific and depend on the location and complications of heterotopic tissue. [3] Typically, heterotopic pancreatic tissue is a sub-mucosal nodule with central umbilication. The diagnosis of ectopic pancreas could be made either by endoscopy or radiological investigation. The definitive diagnosis is made by histopathologic examination. Histopathologic examination reveals normal-appearing pancreatic acinar cells, glands, and sometimes  Islets of Langerhans More Details. Ectopic pancreatic tissue may cause pain, mucosal bleeding and may sometimes be a lead point for intussusception. Treatment of symptomatic ectopic pancreatic tissue is surgical excision.

 
   References Top

1.Dolan RV, ReMine WH, Dockerty MB. The fate of heterotopic pancreatic tissue: A study of 212 cases. Arch Surg 1974;109:762-5.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]  
2.Cano DA, Hebrok M, Zenker M. Pancreatic development and disease. Gastroenterology 2007;132:745-62.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]  
3.Mulholland MW, Simeone DM. Pancreas: Anatomy and structural anomalies: Congenital anomalies: Heterotopic pancreas. In: Yamada T, Alpers DH, Laine L, Owyang C, Powell DW, editors. Textbook of Gastroenterology. 3rd ed. Philadelphia: Lippincott Williams and Wilkins; 1999. p. 2115-9.  Back to cited text no. 3      

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Correspondence Address:
Vipul D Yagnik
Department of Surgery, Pramukhswami Medical College, Karamsad-388 325, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-3767.65179

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