Gastric Outlet Obstruction Caused by Heterotopic Pancreatitis

Abstract

Heterotopic pancreas is defined as the presence of pancreatic tissue outside its normal location in the pancreas and lacking vascular and anatomical continuity with the pancreas. Most commonly it is found along foregut derivatives, such as the stomach, duodenum and jejunum. Less often it is found in Meckel's diverticulum and the bile duct or in even rarer locations. It is frequently encountered incidentally in asymptomatic patients during laparotomy, and is found in approximately 0.5–14% of autopsy studies.[1] Symptomatic patients are rare and do not exhibit any specific set of clinical indicators for this disease. Accordingly, heterotopic pancreas is difficult to diagnose before operation.[2] In our case, a 15-year-old girl presented with a short history of vomiting, weight loss, lack of appetite and upper gastrointestinal bleeding. Laparotomy revealed heterotopic pancreas at the duodenum with signs of inflammation and mucosal ulceration.