Peter Uhrík, Peter Hyrdel, Michal Kalman, Miroslav Pindura, Rudolf Hyrdel
Heterotopic pancreas refers to segments of pancreatic tissue not in continuity with the main body of the pancreas. It
does usually form a tumour in stomach, duodenal and jejunal wall (80% of all heterotopic pancreas). Other intraabdominal
locations include the gallbladder, liver, small intestine, colon, appendix, omentum, and Meckel diverticulum. Extra-
abdominal sites include the lung and umbilicus. It occurs in 2% of the population. The heterotopic pancreas is usually
an asymptomatic condition that is an incidental finding at surgery or autopsy. However, symptoms may include
abdominal pain, nausea, vomiting, gastrointestinal bleeding or other associated symptoms. This case reports a patient
with symptomatic duodenal heterotopic pancreas. Differential diagnosis difficulties are caused by ultrasound visualization
similarities. The heterotopic pancreas may be difficult to differentiate from leiomyomas, gastrointestinal
stromal tumours, fibromas, carcinoid tumours, or other malignant tumours. If a definitive diagnosis is not possible to
be made based on EUS visualisation, EUS-guided histology aspiration should be used to obtain a histological sample.
The treatment of ectopic pancreatic tissue is indicated only for patients who have significant symptoms such as dyspepsia,
recurrent upper gastrointestinal bleeding, biliary or intestinal obstruction, or possible malignant degeneration.