Hospital: Hospital Universitario de Burgos.
Aut@r o Autores: G. Fernandez-Matia, J. Venegas-Gómez, I. Bayona-García, A. Fernández-Fernández, L. Castaño-Martín, J. Pedrosa-Arroyo.
We present a case of a 53-years-old man with history of gastric reflux and pyrosis. He came in many occasions to emergency room to present uncontrollable vomiting and oral intolerance. He drinks 5 alcohol units daily. Non-contrast and contrast multidetector computed tomography (MDCT) showed an ovoid tumor with well defined rim, important cystic component with thick walls located within pylorus. The cystic component is subtly less dense than gastric content (A) . Contrast enhanced CT (CECT) exhibits peripheral tumor enhancement in arterial and venous phase like pancreatic tissue. (B,C). We show also surgical resection of the antrectomy with the tumor (D).
Ectopic pancreas (EP) is an uncommon congenital condition. It may be single or multiple. Frequently is located in gastric antrum, duodenum and jejunum. It can be complicated with pseudocyst and intestinal obstruction (1, 2, 3) . CT findings are flat or ovoid intramural mass that can show cystic degeneration. Frequently it can grow within the bowel. EP has enhancement similar to that normal pancreatic tissue, maybe more intense (4). Differential diagnoses include pancreatic pseudocyst, duodenal cystic dystrophy, gastric duplication cyst, cystic neoplasm (lymphangioma), cystic degeneration of solid neoplasm as schwannoma, gastrointestinal stromal tumor (4, 5). Treatment of EP is surgical resection (3).
Although EP complicated with pseudocyst within gastric pylorus is a rare condition, it can be a cause of intestinal obstruction presented in the emergency room. Radiologist must recognize this disease and its CT findings, because treatment is surgical resection.
- Rezvani M, Menias C, Sandrasegaran K, Olpin J, Elsayes K, Shaaban A. Heteropic pancreas: histopathologic features, imaging findings and complications. RadioGraphics 2017, 37: 484 – 499. - Bryan D, Waxmann I, Matthews B. Gastric obstruction due to int