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A rare case of mesenteric heterotopic pancreas presenting as an inflammatory mass
Yaying Eileen Xu1, Rasika Hendahewa1
1General Surgical Department, Caboolture Hospital, Caboolture, Queensland 4510, Australia.
Abstract:
Heterotopic pancreas (HP) is a rare condition, is commonly asymptomatic and found incidentally at autopsy or during abdominal surgery. HP is usually found in the upper gastrointestinal tract, particularly in the stomach, duodenum and jejunum. Mesenteric heterotopic pancreas (MHP) has been rarely described in the literature, and there has been no reported case under ten years of age. We report a unique case of a 7-year-old African boy who presented with clinical appendicitis and intraoperatively was found to have a necrotic nodular mass in the jejunal mesentery which required segmental small bowel resection. Histology revealed mesenteric heterotopic pancreas with normal pancreatic tissue. As pre-operative diagnosis of MHP is difficult; we encourage a heightened awareness of this condition as a differential diagnosis in children presenting with abdominal pain and an inflammatory mass, which will subsequently aid in the management of these patients.
Insights
This case report details a rare instance of mesenteric heterotopic pancreas (MHP) in a 7-year-old boy, presenting as an inflammatory mass. Early recognition of MHP is crucial for effective pediatric abdominal pain management.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Pathology
Background:
- Heterotopic pancreas (HP) is a rare congenital anomaly where pancreatic tissue is found outside its normal location.
- Mesenteric heterotopic pancreas (MHP) is an exceptionally rare form of HP, with limited pediatric case reports.
- HP is often asymptomatic, discovered incidentally during autopsy or abdominal surgery, typically in the upper GI tract.
Observation:
- A 7-year-old African boy presented with symptoms mimicking appendicitis.
- Intraoperative findings revealed a necrotic nodular mass within the jejunal mesentery.
- The mass necessitated a segmental small bowel resection.
Findings:
- Histological examination confirmed the diagnosis of mesenteric heterotopic pancreas.
- The resected pancreatic tissue was morphologically normal.
- This represents one of the youngest reported cases of MHP.
Implications:
- Pre-operative diagnosis of MHP in children is challenging.
- Increased clinical awareness of MHP is vital for pediatric patients presenting with abdominal pain and inflammatory masses.
- Prompt diagnosis and management can improve patient outcomes.
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