Advances in the diagnosis and treatment of heterotopic pancreas

Abstract

Heterotopic pancreas, a rare congenital malformation, manifests outside the normal pancreas. Research suggests that abnormal embryonic development is linked to the presence of heterotopic pancreas. Three prevailing theories explain its mechanism: Dislocation theory, metaplasia theory, and totipotent stem cell theory. Clinical presentations of heterotopic pancreas are often nonspecific, with most patients being asymptomatic and incidentally discovered during unrelated surgeries or examinations. Endoscopic ultrasound, computed tomography, and magnetic resonance imaging are commonly employed diagnostic tools for heterotopic pancreas. However, the accuracy of diagnosis based on these methods is not consistently high, necessitating histopathological confirmation in many cases. Treatment options for heterotopic pancreas typically involve endoscopic resection, surgical resection, or observation through follow-up.

Keywords: Heterotopic pancreas; Ultrasound endoscopy; Enhanced computed tomography; Endoscopic therapy; Surgery

Core Tip: Heterotopic pancreas is rare, and its clinical presentation lacks specificity, posing challenges in diagnosis and differential diagnosis. Endoscopic ultrasound, computed tomography, and magnetic resonance imaging are the predominant diagnostic methods used for heterotopic pancreas. However, the diagnostic accuracy based on these imaging techniques is not consistently high, often necessitating histopathological confirmation. Clinicians should possess a thorough understanding of the clinical symptoms and imaging findings associated with this condition, as well as the key factors differentiating from other gastrointestinal disorders. Treatment strategies, such as endoscopic resection, surgical resection, or close monitoring, should be tailored based on comprehensive assessments considering factors such as the location, size, and clinical manifestations of heterotopic pancreas.