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Ectopic pancreas associated with a choledochal cyst and extrahepatic biliary atresia
T R Prasad1, S D Gupta, V Bhatnagar
1Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi.
Insights
Two children with ectopic pancreatic tissue were found during surgery for biliary atresia and choledochal cysts. Excision is recommended to prevent serious complications from this pancreatic tissue.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Surgical Pathology
Background:
- Ectopic pancreatic tissue is a rare congenital anomaly.
- Extrahepatic biliary atresia (EHBA) and choledochal cysts (CC) are significant pediatric hepatobiliary conditions.
- The co-occurrence of these conditions with ectopic pancreas is exceptionally rare.
Observation:
- This report details two pediatric cases where ectopic pancreatic tissue in the jejunum was incidentally discovered during surgical correction for EHBA and CC.
- Literature review revealed no prior reports of CC associated with ectopic pancreas and only one case of EHBA with ectopic pancreas.
Findings:
- The study highlights the rare association between EHBA/CC and ectopic pancreatic tissue.
- The incidental finding of ectopic pancreatic tissue necessitates careful consideration despite the absence of symptoms.
Implications:
- Surgical excision of incidentally detected ectopic pancreatic tissue is advised, even in asymptomatic patients.
- This prophylactic measure aims to mitigate risks of future complications, including pancreatitis, cystic degeneration, and malignant transformation.
- Early detection and management are crucial for improving long-term outcomes in pediatric patients with these rare conditions.
Abstract:
Two children with incidentally-diagnosed ectopic pancreatic tissue in the jejunum at surgery for extrahepatic biliary atresia (EHBA) and choledochal cyst (CC) are reported. No case has been reported in the literature describing the association of a CC with ectopic pancreas, and only one case of EHBA associated with ectopic pancreas has been reported. We believe that incidentally-detected ectopic pancreatic tissue should be excised, even though the patient is symptom-free, in order to prevent the risk of serious complications due to either the mass effect or the potential for acute pancreatitis, cystic degeneration, or malignant transformation at a later date.