CONTEXT: Cystic dystrophy in heterotopic pancreas is a rare and serious condition. Diagnosis is difficult because of non-specific clinical manifestations and radiologic and endoscopic imaging are pivotal. Therapeutic management is still under debate. CASE REPORT: We describe a case of cystic dystrophy of the duodenal wall in heterotopic pancreas complicated with chronic pancreatitis and pancreatic cystadenoma. DISCUSSION: Computed tomography and magnetic resonance are very useful in demonstrating the presence of cysts in a thickened duodenal wall but, for the most part, endoscopic ultrasonography is the most useful imaging examination. The choice of different therapeutic options is still under debate; although some authors have proposed a medical approach using octreotide or endoscopic treatment for selected patients, a pancreaticoduodenectomy is usually proposed for symptomatic patients. CONCLUSION: When surgery is needed, a pancreaticoduodenectomy is preferred, reserving by-pass procedures for high risk patients. Because of the non-specific clinical manifestation and the very difficult diagnosis and therapeutic management, these patients should be studied and treated in specialized and dedicated centers.
CONTEXT: Cystic dystrophy in heterotopic pancreas is a rare and serious condition. Diagnosis is difficult because of non-specific clinical manifestations and radiologic and endoscopic imaging are pivotal. Therapeutic management is still under debate. CASE REPORT: We describe a case of cystic dystrophy of the duodenal wall in heterotopic pancreas complicated with chronic pancreatitis and pancreatic cystadenoma. DISCUSSION: Computed tomography and magnetic resonance are very useful in demonstrating the presence of cysts in a thickened duodenal wall but, for the most part, endoscopic ultrasonography is the most useful imaging examination. The choice of different therapeutic options is still under debate; although some authors have proposed a medical approach using octreotide or endoscopic treatment for selected patients, a pancreaticoduodenectomy is usually proposed for symptomatic patients. CONCLUSION: When surgery is needed, a pancreaticoduodenectomy is preferred, reserving by-pass procedures for high risk patients. Because of the non-specific clinical manifestation and the very difficult diagnosis and therapeutic management, these patients should be studied and treated in specialized and dedicated centers.
Authors: Michael T LeCompte; Brandon Mason; Keenan J Robbins; Motoyo Yano; Deyali Chatterjee; Ryan C Fields; Steven M Strasberg; William G Hawkins Journal: World J Gastroenterol Date: 2022-04-14 Impact factor: 5.374
Authors: Soroush Larjani; Vanessa R Bruckschwaiger; Leslie A Stephens; Paul D James; Guillaume Martel; Richard Mimeault; Fady K Balaa; Kimberly A Bertens Journal: Int J Surg Case Rep Date: 2017-07-25
Authors: V I Egorov; A N Vankovich; R V Petrov; N S Starostina; A Ts Butkevich; A V Sazhin; E A Stepanova Journal: Biomed Res Int Date: 2014-06-05 Impact factor: 3.411