Ligation-assisted endoscopic mucosal resection of gastric heterotopic pancreas

doi:10.3748/wjg.15.2805

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Jun 14, 2009; 15(22): 2805-2808
Published online Jun 14, 2009. doi: 10.3748/wjg.15.2805

Ligation-assisted endoscopic mucosal resection of gastric heterotopic pancreas

Mouen A Khashab, Oscar W Cummings, John M DeWitt

Mouen A Khashab, John M DeWitt, Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, IN 46202, United States

Oscar W Cummings, Department of Pathology, Indiana University School of Medicine, Indianapolis, IN 46202, United States

Author contributions: Khashab MA, DeWitt JM wrote and edited the manuscript; Cummings OW edited the pathology section of the manuscript.

Correspondence to: John M DeWitt, MD, Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University, School of Medicine, IN 46202, United States. jodewitt@iupui.edu

Telephone: +1-317-2741113

Fax: +1-317-2788144

Received: October 13, 2008
Revised: November 26, 2008
Accepted: December 3, 2008
Published online: June 14, 2009

Abstract

Heterotopic pancreas is a congenital anomaly characterized by ectopic pancreatic tissue. Treatment of heterotopic pancreas may include expectant observation, endoscopic resection or surgery. The aim of this report was to describe the technique of ligation-assisted endoscopic mucosal resection (EMR) for resection of heterotopic pancreas of the stomach. Two patients (both female, mean age 32 years) were referred for management of gastric subepithelial tumors. Endoscopic ultrasound in both disclosed small hypoechoic masses in the mucosa and submucosa. Band ligation-assisted EMR was performed in both cases without complications. Pathology from the resected tumors revealed heterotopic pancreas arising from the submucosa. Margins were free of pancreatic tissue. Ligation-assisted EMR is technically feasible and may be considered for the endoscopic management of heterotopic pancreas.

Keywords: Endoscopic mucosal resection, Endoscopic ultrasound, Heterotopic pancreas