Rare gastric outlet obstruction owing to ectopic pancreas: a case report and literature review

Gastric Ectopic Pancreas With Pseudocyst Formation Causing Gastric Outlet Obstruction

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.

Management of gastric ectopic pancreas identified in preoperative evaluation of bariatric surgery - A case report

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The diagnosis of rare gastric lesions has become more frequent after the increase in bariatric surgery.

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The preoperative evaluation for bariatric surgery showed two lesions suggestive of Gastric Ectopic Pancreas.

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The previous identification of these lesions provides better surgical planning.

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Intraoperative Upper Endoscopy was used to identify the location of these lesions.

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Simultaneous laparoscopic resection of the lesions associated with Sleeve Gastrectomy was performed.

Background

The diagnosis of gastric lesions, such as the Ectopic Gastric Pancreas (GEP), has become more frequent after the increase in bariatric surgeries. The most frequently used surgical options are: Sleeve Gastrectomy (SG) and Roux-en-Y Gastric Bypass (RYGB). The scientific papers about GEP in Bariatric Surgery consisted of intraoperative findings, approach the lesion with gastrectomy and the need to change the initial surgical strategy of the Sleeve for others techniques which allow extended gastric resections.

Presentation of case

This is a report on a 21-year-old female patient with class 3 obesity whose preoperative evaluation showed two lesions suggestive of GEP. Simultaneous surgical video-laparoscopic treatment of lesions associated with SG aided by intraoperative Upper Endoscopy (UE) was performed with no perioperative complications.

Conclusion

It is possible to associate the treatment of rare gastric lesions with traditional surgery techniques for obesity.