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Published on: November 20, 2021
Clinical features and treatment of heterotopic pancreas in children: a multi-center retrospective study
Xiaofeng Yang1, Chen Liu2, Shuai Sun1
1Department of Pediatric Surgery, Binzhou Medical University Hospital, Binzhou, China.
Insights
Heterotopic pancreas in children is often asymptomatic. Lesions in Meckel's diverticulum frequently have accompanying gastric mucosa heterotopia, necessitating surgical or endoscopic resection for pediatric patients.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Surgical Pathology
Background:
- Heterotopic pancreas is a rare congenital anomaly.
- It presents diagnostic and therapeutic challenges in pediatric cases.
- Understanding its clinical features is crucial for effective management.
Purpose of the Study:
- To evaluate the clinical characteristics of pediatric heterotopic pancreas.
- To review treatment strategies for this condition in children.
- To identify factors influencing presentation and management.
Main Methods:
- Retrospective analysis of 88 pediatric patients diagnosed between 2000 and 2022.
- Categorization into symptomatic and asymptomatic groups.
- Statistical analysis of clinical parameters, lesion characteristics, and treatment outcomes.
Main Results:
- Most pediatric heterotopic pancreas cases were asymptomatic (75%).
- Common locations include Meckel's diverticulum (46.59%) and jejunum (20.45%).
- Lesions in Meckel's diverticulum often co-occur with gastric mucosa heterotopia (80.49%).
Conclusions:
- Symptomatic presentation is infrequent in pediatric heterotopic pancreas.
- Resection via open, laparoscopic, or endoscopic approaches is recommended.
- Further multicenter studies are needed to refine treatment guidelines.
Objective:
Heterotopic pancreas, an uncommon condition in children, can present with diagnostic and treatment challenges. This study aimed to evaluate the clinical features and treatment options for this disorder in pediatric patients.
Methods:
We conducted a retrospective analysis, including patients diagnosed with heterotopic pancreas at four tertiary hospitals between January 2000 and June 2022. Patients were categorized into symptomatic and asymptomatic groups based on clinical presentation. Clinical parameters, including age at surgery, lesion size and site, surgical or endoscopic approach, pathological findings, and outcome, were statistically analyzed.
Results:
The study included 88 patients with heterotopic pancreas. Among them, 22 were symptomatic, and 41 were aged one year or younger. The heterotopic pancreas was commonly located in Meckel's diverticulum (46.59%), jejunum (20.45%), umbilicus (10.23%),ileum (7.95%), and stomach (6.82%). Sixty-six patients had concomitant diseases. Thirty-three patients had heterotopic pancreas located in the Meckel's diverticulum, with 80.49% of cases accompanied by gastric mucosa heterotopia (GMH). Patients without accompanying GMH had a higher prevalence of heterotopic pancreas-related symptoms (75%). Treatment modalities included removal of the lesions by open surgery, laparoscopic or laparoscopic assisted surgery, or endoscopic surgery based on patient's age, the lesion site and size, and coexisting diseases.
Conclusions:
Only one-fourth of the patients with heterotopic pancreas presented with symptoms. Those located in the Meckel's diverticulum have commonly accompanying GMH. Open surgical, laparoscopic surgical or endoscopic resection of the heterotopic pancreas is recommended due to potential complications. Future prospective multicenter studies are warranted to establish rational treatment options.
