Chronic obstructive pancreatitis, nesidioblastosis, and small endocrine pancreatic tumor

A patient is described in whom a small 0.8-mm-diameter endocrine tumor was found in association with localized pancreatitis, stricture of the main pancreatic duct, and nesidioblastosis. The endocrine tumor, localized 7 mm from the main duct, obstructed a collateral pancreatic duct and four of its branches. Pancreatitis was localized into two areas. It was fairly severe in a small area of the body drained by the obstructed collateral duct and extended around it, reaching the main pancreatic duct which was partly occluded at this level by periductal fibrosis. Pancreatitis was mild in the left part of the pancreas distally from the incomplete stricture of the main duct. The head and body of the pancreas between the stricture and the duodenum were normal. Nesidioblastosis was present in the obstructed parts of the pancreas. It is suggested that the tumor could have caused pancreatitis, stenosis of the main duct, and nesidioblastosis.