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1 . 2022

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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CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

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