Ectopic Pancreas
Pancreas tissue not connected to pancreas for blood supply or anatomical structure
Most prevalent in stomach; commonly within 6cm of pylorus on greater curve
Incidence of 0.5 – 13% on autopsies
Investigation:
OGD
EUS + FNA can be diagnostic if required (pancreas will be within submucosa or intrinsic muscle layer)
Treatment:
– Recently, endoscopic treatment is preferred if possible – ESD, STER (submucosal tunnel endoscopic resection) etc..
– Sometimes ligation alone will suffice
– If growth has gone through entire wal of the organ, then local excision is needed.
– If any possibility of cancer, then aggressive surgical resection is necessary
– If symptomatic, then treatment is essential
– If asymptomatic, (Am J Gastro; 2023)
o Most experts would diagnose with EUS +FNA and once confirmed, no further follow-up necessary (58%), independent of size
o 38% would follow-uop if >20mm, 2-yearly OGD (stop if appearance is stable)
o If no histological diagnoses, repeat EUS as follow-up (48%)
o If >50% change in size, opt for resection (EMR/ESD/Surgical)