Журнал клинических случаев

Heterotopic Pancreatic Tissue in Gall Bladder: A Rare Entity

Abstract

Parul Gupta, Neema Tiwari, Nirupama Lal and Srivastava AN

Introduction: Pancreatic heterotopia is a rare pathological entity and its localization in gall bladder is extremely rare. It is mostly asymptomatic incidental finding and rarely gives rise to complications. It can be associated with incidental finding or can be symptomatic or may cause complication. Heterotopic pancreas (HP) also referred to as ectopic pancreas, pancreatic choristoma, or pancreatic rest, is defined as the aberrantly located pancreatic tissue in an anomalous location without any anatomic, vascular, or neural continuity with the main body of the normal pancreas. The most common location for HP is the duodenum, upper jejunum and stomach.

Case report: A 35 year male was admitted to the Surgical Department of Era’s Lucknow Medical College and Hospital for an elective laparoscopic cholecystectomy. He had complains of sporadic flatulence after meals and belching. His gall bladder was resected post an USG revealing Gall stones and sent for histopathology where he was diagnosed as a case of heterotopic pancreas in the GB neck with chronic cholecystitis.

Discussion: Localization of pancreatic heterotopia in gall bladder is the second most prevalent pancreatic anomaly but an extremely rare finding. The incidence in gastrointestinal tract is estimated to be from 0.55% to 13.7% on autopsy, and 0.2% in laparatomy. Most commonly these are incidental findings but some studies have implicated them as causative factors in the genesis of cholecystitis, obstructions etc.

Conclusion: HP of the gallbladder may cause clinical symptoms such as cholecystitis as well as complications which can be fatal and hence this condition should be taken into consideration in patients with symptomatic gallbladder disease.