A case report of ectopic pancreas in the ileum incidentally diagnosed during laparotomy for acute colonic diverticulitis

Abstract

Ectopic or heterotopic pancreas (EP) is defined as pancreatic tissue lacking anatomic or vascular connections with the orthotopic pancreas. It is a rare entity that occasionally causes symptoms, in fact most cases are asymptomatic and they are diagnosed incidentally at laparotomy or during autopsy. This case report describes a 75-year-old woman presenting with acute colonic diverticulitis, scheduled for elective surgery. The preoperative CT virtual colonoscopy revealed a persistently enhanced mass in the proximal ileum, which was suspected for GIST or NET. Histopathological examination revealed pancreatic tissue without evidence of malignancy. Although the rarity of this clinical condition, it is necessary to be aware that jejunal EP can lead to complications, such as bleeding or jejunojejunal intussusception. Resection is the management of choice for incidentally found lesions assuming that the diagnosis of EP and exclusion of neoplasm may not be possible without a histological specimen.