Clinical significance of pancreatic ectopia in various organs (literature review and cases of symptomatic and asymptomatic course)
Abstract
Background. Ectopia of the pancreas is a rare anomaly
characterized in the anlage of the normal pancreatic tissue in other organs. In
the presence of nonspecific clinical manifestations, most of the cases are
diagnosed at an early age. The variability of the clinical picture depends on
the location and size of the pancreatic ectopia, which complicates the
diagnosis. An ectopic pancreas can be located in any segment of the gastrointestinal
tract, but more often in its upper sections. The prevalence of the anomaly
ranges from 0.6 to 13%, however, the true figure remains unknown to date due to
the predominantly asymptomatic course of the anomaly. As a rule, an ectopic
pancreas is detected by chance intraoperatively or during examination for
another pathology. The anomaly begins to manifest itself only with the
development of complications, often manifesting gastrointestinal bleeding,
obstructive or abdominal pain syndromes, perforations of hollow organs.
Diagnosis at the preoperative stage is rather complicated, and in particular,
it is associated with difficulties in differential diagnosis with malignant
neoplasms, for example, gastrointestinal stromal tumors of the stomach. The
final diagnosis is made only after histological examination. Occasionally, foci
of malignancy may appear in the ectopic pancreas. Symptomatic and complicated
forms are subject to treatment. Resection is the method of choice. In the case
of asymptomatic forms, regular monitoring and monitoring of possible
complications is usually sufficient.
Аim – analysis of clinical and instrumental features of pancreatic ectopia
diagnosis.
Material and methods. A brief analysis of the literature
and demonstration of our own clinical observations of this anomaly are
presented.
Results. Various variants of clinical manifestations of
pancreatic ectopia are presented.
Conclusion. Despite the
relative rarity of pancreatic ectopia, it should be excluded in the
differential diagnosis of asymptomatic submucosal formations of the
gastrointestinal tract. The clinical significance of asymptomatic pancreatic
ectopias is not fully understood. When is impossibile to perform of morphological verification of the diagnosis and exclude of the
oncological process, the identified masses are treated in accordance with the
clinical guidelines for the alleged oncological diagnosis. Complicated ectopias
of the pancreas must be surgically removed.
Keywords:ectopic pancreas; pancreatic anomalies; differential diagnosis of pancreatic formations
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Semenkov A.V., Pyhteev D.A., Malyuga V.Yu., Setdikova
G.R., Stepanova E.A., Makkaeva Z.M., Tulskih D.A., Boldyrev M.A., Skugarev A.L.
Clinical significance of pancreatic ectopia in various organs (literature
review and cases of symptomatic and asymptomatic course). Clinical and
Experimental Surgery. Petrovsky Journal. 2022; 10 (1): 135–43. DOI: https://doi.org/10.33029/2308-1198-2022-10-1-135-143
(in Russian)
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