DOZ047.75: Ectopic pancreas in children with esophageal atresia: not an incidental association

Abstract

Abstract Aim of the Study Ectopic pancreas (EP) is pancreatic tissue lacking vascular or anatomic connection with the main body of the pancreas. Incidence in the general population ranges between 0.15% and 5.2%, and it is most commonly located in the stomach. It is usually asymptomatic, but it can lead to intestinal occlusion, bleeding, or malignant degeneration. After a patient with esophageal atresia (EA) debuted with a symptomatic EP, we aimed to determine EP incidence in our series of EA patients. Method Prospective single center review (2016–2018) was performed of children with upper gastrointestinal diseases who underwent diagnostic or therapeutic esophagogastroduodenoscopy (EGD). Patients were divided according to main diagnosis and gastric EP was actively searched for in every case. Results EGD was performed in 192 patients and the main diagnoses were EA in 53 (27.60%), eosinophilic esophagitis in 37 (19.27%), celiac disease in 23 (11.97%), and other upper gastrointestinal disorders in 79 (41.14%). EP was found in 7 cases (4 ♂/3 ♀), all of them in the EA group (7/53, 13.2%). Out of the 7, 4 had type III EA and in every case the EP was found at a prepyloric location. One patient debuted with hematemesis, so surgical excision was performed. Since the remaining 6 are asymptomatic, conservative treatment has been proposed. PE was not found in any of the other groups (P < 0.05). Conclusion In this series, the incidence of EP in children with EA was higher (13.2%) than the one found in other groups (0%) or in the general population (0.15%–5.2%). These findings suggest that there is an association between EP and EA. Ectopic pancreas should be ruled out in every patient with esophageal atresia due to its potential morbidity, and when found, long-term follow-up is advisable.