Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 14, 2017; 23(34): 6365-6370
Published online Sep 14, 2017. doi: 10.3748/wjg.v23.i34.6365
Interventional endoscopic ultrasound for a symptomatic pseudocyst secondary to gastric heterotopic pancreas
Hang-Bin Jin, Lei Lu, Jian-Feng Yang, Qi-Feng Lou, Jing Yang, Hong-Zhang Shen, Xiao-Wei Tang, Xiao-Feng Zhang
Hang-Bin Jin, Lei Lu, Jian-Feng Yang, Qi-Feng Lou, Jing Yang, Hong-Zhang Shen, Xiao-Wei Tang, Xiao-Feng Zhang, Department of Gastroenterology, Hangzhou First People’s Hospital, Nanjing Medical University, Hangzhou 310000, Zhejiang Province, China
Author contributions: All authors contributed to the acquisition of data, writing, and revision of this manuscript.
Institutional review board statement: This case report was reviewed and approved by the Hangzhou First People’s Hospital Institutional Review Board.
Informed consent statement: The patient and his family provided informed written consent.
Conflict-of-interest statement: All the authors have no conflicts of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Xiao-Feng Zhang, Department of Gastroenterology, Hangzhou First People’s Hospital, Nanjing Medical University, Hangzhou 310000, Zhejiang Province, China. zxf837@tom.com
Telephone: +86-13758250208
Received: June 4, 2017
Peer-review started: June 6, 2017
First decision: June 22, 2017
Revised: July 10, 2017
Accepted: August 2, 2017
Article in press: August 2, 2017
Published online: September 14, 2017
Abstract

Heterotopic pancreas (HP) is a relatively uncommon entity that is defined as pancreatic tissue without a true anatomical or vascular connection to the pancreas. HP does not cause symptoms in most cases but can occasionally produce various manifestations, including nausea, vomiting, abdominal pain, and even heterotopic pancreatitis. Here, we report an unusual case in which heterotopic pancreatitis complicated by the formation of a pseudocyst that caused gastric outlet obstruction was diagnosed based on serum hyperamylasemia and findings from endoscopic ultrasonography (EUS)-guided fine needle aspiration (EUS-FNA) cytology. EUS-guided single pigtail stent insertion was successfully performed for recurrent gastric outlet obstruction. The patient has remained healthy and symptom-free during 4 years of surveillance. In the context of the relevant literature, the described case is a rare case of HP complicated by a pseudocyst treated via EUS-FNA and stent insertion.

Keywords: Heterotopic pancreas, Pseudocyst, Gastric outlet obstruction, Endoscopic ultrasound-guided fine needle aspiration

Core tip: Heterotopic pancreas (HP), which is defined as the atypical presence of pancreatic tissue without an anatomical or vascular connection to the pancreas, is relatively rare. As an intra- or submucosal lesion, HP is typically asymptomatic and found incidentally. We report a case involving a 40-year-old man with gastric outlet obstruction secondary to pseudocyst formation in HP.