Ectopic Pancreas Bleeding in the Jejunum Revealed by Capsule Endoscopy

Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
Clinical Endoscopy 09/2012; 45(3):194-7. DOI: 10.5946/ce.2012.45.3.194
Source: PubMed


Ectopic pancreas is defined as pancreatic tissue found outside the usual anatomic location. It is often found incidentally at different sites in the gastrointestinal (GI) tract. The incidence of ectopic pancreatic tissue in autopsy series is 1% to 2%, with 70% of the ectopic lesions found in the stomach, duodenum and jejunum. Although it is usually a silent anomaly, an ectopic pancreas may become clinically evident when complicated by inflammation, bleeding, obstruction or malignant transformation. We report a case of ectopic pancreas located in the jejunum and presenting as an obscure GI bleeding, which was diagnosed by capsule endoscopy.

Download full-text


Available from: Do Sang Lee, Jun 05, 2014
18 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Gastric ectopic pancreas is an uncommon developmental anomaly and its histological diagnosis is usually difficult by using a conventional biopsy forceps. In the literature, most cases of gastric ectopic pancreas were usually diagnosed by gross pattern during endoscopic examination or features of endoscopic ultrasound. In contrast, this disease was seldom diagnosed by histology in clinical practice. Although the typical endoscopic ultrasonographic features of ectopic pancreas include heterogeneous echogenicity, indistinct borders, and a location within 2 or more layers, it can also exhibit hypoechoic homogeneous echogenicity and a distinct border within the fourth sonographic layer (muscularis propria) similar to the endoscopic ultrasonographic features of gastrointestinal stromal tumors. In our study, we found that 53% of gastric ectopic pancreas originated within the fourth sonographic layer, demonstrating hypoechoic, homogeneous echogenicity, and distinct borders. Therefore, recognizing endoscopic ultrasonographic features, combining with deep biopsy, endoscopic ultrasound-guided fine needle aspiration/core needle biopsy can prevent conducting unnecessary resection. Surgical resection is the mainstay treatment for symptomatic gastric ectopic pancreas, but endoscopic resection using endoscopic mucosal resection or endoscopic submucosal dissection technique provides an alternative method of removing superficial-type and deep-type gastric ectopic pancreas.
    Gastroenterology Research and Practice 10/2014; 2014:160601. DOI:10.1155/2014/160601 · 1.75 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Neoplasms of the small bowel are rare, accounting for only 2 % of all primary gastrointestinal tumors. The incidence is less than 1.0 per 100,000 in the world [1]. Men have a slightly higher incidence than women, and the median age of diagnosis is in the mid-60s [2]. About 20 % are localized in the duodenum. Approximately 40 different histologic types have been identified; only one third of those are benign [3].
    Video Capsule Endoscopy, 01/2014: pages 317-336; , ISBN: 978-3-662-44061-2
  • Endoscopy 01/2014; 46(S 01):E297-E298. DOI:10.1055/s-0034-1365747 · 5.05 Impact Factor
Show more