Arizmendi-Gutiérrez A, García-Herrera OJ, Islas-Cristalinas A, Núñez-Trenado LA

Language: Spanish
References: 10
Page: 122-125
PDF size: 872.75 Kb.

ABSTRACT

Introduction: ectopic pancreas is a congenital benign subepithelial tumor located in an abnormal anatomical position, lacking vascular and ductal continuity with the main pancreas. Its prevalence has been reported to range from 0.55 to 13.7% in autopsies and in 1 out of every 500 upper abdominal surgeries. Between 70 and 90% of lesions are discovered in the stomach, duodenum, or jejunum. The clinical presentation is usually asymptomatic, with significant variability in symptomatic cases, ranging from abdominal pain, upper gastrointestinal bleeding, or dyspepsia to peritonitis and acute abdomen. Diagnosis is confirmed by histopathological examination, and treatment is based on surgical resection via laparoscopy. Clinical case: a 46-year-old male presented in 2020 with generalized, sharp abdominal pain accompanied by sporadic hematochezia and melena, as well as unintentional weight loss of 10 kilograms, asthenia, and adynamia. A multislice contrast-enhanced computed tomography scan was initiated, revealing a subepithelial lesion with hypervascular behavior at the mesenteric border of the proximal jejunum, 8 cm from the ligament of Treitz. Surgical treatment was decided upon, consisting of laparoscopic resection of the lesion via gastrojejunostomy. Histopathological examination revealed ectopic pancreas. Conclusion: this case demonstrates the diagnostic importance of performing abdominal tomography and intraoperative endoscopy in cases of obscure lower gastrointestinal bleeding. Laparoscopic intestinal resection is a safe and effective treatment, even for lesions of the proximal intestine.

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