Diagnosis and therapeutic management of cystic dystrophy of the duodenal wall in heterotopic pancreas. A case report and revision of the literature(1189 views) Galloro G, Napolitano V, Magno L, Diamantis G, Nardone G, Bruno M, Mollica C, Persico G
Jop (ISSN: 1590-8577, 1590-0857), 2008 Nov 03; 9(6): 725-732.
Department of General Geriatric Oncological Surgery and Advanced Technology, University of Naples Federico II, School of Medicine, Via S. Pansini 5, 80131 Naples, Italy
Department of Biomorphological and Functional Sciences, University of Naples Federico II, School of Medicine, Via S. Pansini 5, 80131 Naples, Italy
Department of Clinical and Experimental Medicine, University of Naples Federico II, School of Medicine, Via S. Pansini 5, 80131 Naples, Italy
Department of Internal Clinical and Experimental Medicine, F. Magrassi and A. Lanzara, Second University of Naples, Naples, Italy
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Lai, E. C. S., Tompkins, R. K., Heterotopic pancreas. Review of a 26 year expeirence (1986) Am J Surg, 151, pp. 697-700
Armstrong, C. P., King, P. M., Dixon, J. M., Macleod, I. B., The clinical significance of heterotopic pancreas in the gastrointestinal tract (1981) Br J Surg, 68, pp. 384-387
Doland, R. V., ReMine, W. H., Dockerty, M. B., The fate of heterotopic pancreatic tissue. A study on 212 cases (1974) Arch Surg, 109, pp. 762-765
30: 580-6Fekete, F., Noun, R., Sauvanet, A., Flejou, J. F., Bernardes, P., Belghiti, J., Pseudotumor developing in heterotopic pancreas (1996) W J Surg, 20, pp. 295-298
Flejou, J. F., Potet, F., Molas, G., Bernades, P., Amouyal, P., Fekete, F., Cystic dystrophy of the gastric and duodenal wall developing in heterotopic pancreas: An unrecognised entity (1993) Gut, 34, pp. 343-347
Bartels, R. J., Duplication of the stomach. Case report and review of the literature (1967) Ann Surg, 33, pp. 747-752
Skinazi, F., L vy, P., Molas, G., Fl jouJF, Dystrophie kystique de la paroi duod nale sans pancr atite chronique alcoolique. (1994) Gastroenterol Clin Biol, 18, pp. A86
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Diagnosis and therapeutic management of cystic dystrophy of the duodenal wall in heterotopic pancreas. A case report and revision of the literature
CONTEXT: Cystic dystrophy in heterotopic pancreas is a rare and serious condition. Diagnosis is difficult because of non-specific clinical manifestations and radiologic and endoscopic imaging are pivotal. Therapeutic management is still under debate. CASE REPORT: We describe a case of cystic dystrophy of the duodenal wall in heterotopic pancreas complicated with chronic pancreatitis and pancreatic cystadenoma. DISCUSSION: Computed tomography and magnetic resonance are very useful in demonstrating the presence of cysts in a thickened duodenal wall but, for the most part, endoscopic ultrasonography is the most useful imaging examination. The choice of different therapeutic options is still under debate; although some authors have proposed a medical approach using octreotide or endoscopic treatment for selected patients, a pancreaticoduodenectomy is usually proposed for symptomatic patients. CONCLUSION: When surgery is needed, a pancreaticoduodenectomy is preferred, reserving by-pass procedures for high risk patients. Because of the non-specific clinical manifestation and the very difficult diagnosis and therapeutic management, these patients should be studied and treated in specialized and dedicated centers.
Diagnosis and therapeutic management of cystic dystrophy of the duodenal wall in heterotopic pancreas. A case report and revision of the literature
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