Gastroesophageal junction pancreatic heterotopia/metaplasia: a case series

Gastroesophageal junction pancreatic heterotopia is an uncommon congenital condition where pancreatic tissue is present outside its normal anatomical location. We present a case series of four patients who have presented with nonspecific, vague gastrointestinal symptoms that included abdominal pain, dyspepsia, and heartburn. Endoscopy was performed and revealed irregular Z-lines in three out of the four patients, with high suspicion of Barrett's esophagus. Further histopathologic evaluation confirmed ectopic pancreatic tissue in all four patients, two of whom had mild chronic inflammation, another presented with chronic gastritis as well as reflux esophagitis, and the last patient exhibited intestinal metaplasia. Also, three patients were treated with proton pump inhibitors and were kept under constant surveillance, while one patient was lost to follow-up. Pancreatic heterotopia involving the gastroesophageal junction is a rare presentation that usually goes unnoticed due to its asymptomatic nature. It is important that clinicians recognize such presentations to provide optimal treatment.