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Gastric Ectopic Pancreas With Pseudocyst Formation Causing Gastric Outlet Obstruction. ACG Case Rep J 2023; 10:e00988. [PMID: 36788791 PMCID: PMC9916032 DOI: 10.14309/crj.0000000000000988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/17/2023] [Indexed: 02/11/2023] Open
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.
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Gadelha Bezerra Silva B, Veras Oliveira A, Almeida de Sousa Jucá M, de Sousa Nóbrega AG, Lopes PM, Feitosa Gomes JW, Alencar Barros AÁ. Management of gastric ectopic pancreas identified in preoperative evaluation of bariatric surgery - A case report. Int J Surg Case Rep 2020; 77:353-356. [PMID: 33217652 PMCID: PMC7683285 DOI: 10.1016/j.ijscr.2020.10.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 10/22/2020] [Indexed: 11/24/2022] Open
Abstract
The diagnosis of rare gastric lesions has become more frequent after the increase in bariatric surgery. The preoperative evaluation for bariatric surgery showed two lesions suggestive of Gastric Ectopic Pancreas. The previous identification of these lesions provides better surgical planning. Intraoperative Upper Endoscopy was used to identify the location of these lesions. 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.
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Affiliation(s)
- Bruno Gadelha Bezerra Silva
- Surgery Department, Division of General Surgery, Hospital José Martiniano de Alencar, 1526, Princesa Isabel Street, Centro District, Fortaleza, Ceará, Brazil.
| | - Adriano Veras Oliveira
- Surgery Department, Division of Bariatric and Metabolic Surgery, Hospital José Martiniano de Alencar, 1526, Princesa Isabel Street, Centro District, Fortaleza, Ceará, Brazil.
| | - Marcio Almeida de Sousa Jucá
- Surgery Department, Division of Bariatric and Metabolic Surgery, Hospital José Martiniano de Alencar, 1526, Princesa Isabel Street, Centro District, Fortaleza, Ceará, Brazil.
| | - Antônio Gláucio de Sousa Nóbrega
- Surgery Department, Division of Bariatric and Metabolic Surgery, Hospital José Martiniano de Alencar, 1526, Princesa Isabel Street, Centro District, Fortaleza, Ceará, Brazil.
| | - Paulo Marcos Lopes
- Surgery Department, Division of Bariatric and Metabolic Surgery, Hospital José Martiniano de Alencar, 1526, Princesa Isabel Street, Centro District, Fortaleza, Ceará, Brazil
| | - José Walter Feitosa Gomes
- Surgery Department, Division of General Surgery, Hospital José Martiniano de Alencar, 1526, Princesa Isabel Street, Centro District, Fortaleza, Ceará, Brazil.
| | - André Átila Alencar Barros
- Endoscopy Department, Division of Upper Gastrointestinal Endoscopy, Hospital José Martiniano de Alencar, 1526, Princesa Isabel Street, Centro District, Fortaleza, Ceará, Brazil.
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