Heterotopic Pancreas in Duodenum: A Case Report

Heterotopic pancreas is pancreatic tissue found outside the usual anatomic location of the pancreas. It is often an incidental finding and can be found at different sites in the gastrointestinal tract. It usually remains asymptomatic, but becomes clinically evident when complicated by pathologic changes such as inflammation, bleeding, obstruction and malignant transformation. Here, we report a 33-year-old male presented at Out Patient Department with chief complaint of epigastric pain. An upper gastrointestinal endoscopy was done which revealed nodular sub mucosal lesion at first part of duodenum measuring 1.5 cm with an adjoining area showing ulcer with active bleeding. Biopsy was taken from the representative site. On gross examination, specimen consists of single piece of grey white nodular tissue. Microscopic examination revealed lobular architecture of ectopic pancreas under intact normal duodenal mucosa and in between smooth muscle fibres of muscularispropria. Pancreatic tissue consists of mixture of pancreatic acini, ducts and islets of Langerhans.