Fahad Bamehriz, MD1, Mohammed N Alali, MD1, Hassan Arishi, MD2, Waad Yahya Yaseen, MD3, Mohammed Alswayyed, Assistant Professor and Consultant Pathologist1, Abdullah Aldohayan, Professor and Consultant in Surgery1. 1King Khalid University Hospital,college of medicine,KSU, Riyadh,KSA, 2King Abdulaziz Medical City, National Guard health affair, Riyadh,KSA, 3AlNoor hospital, Ministry of health, Makkah
Introduction: Pancreatic heterotopia or Heterotopic pancreas (HP) is the presence of pancreatic tissue outside the normal anatomical boundaries. It is usually found in the upper gastrointestinal tract – specifically, the stomach, duodenum, and proximal jejunum. The incidence of HP is 0.25-1.2%.
HP is usually asymptomatic and diagnosed during histopathological examinations with extremely rare malignant transformation.
We are reporting the first case report of incidentaloma of duodenal HP in obese patients during laparoscopic sleeve gastrectomy (LSG).
Case report: A 15 year-old male obese patient (body mass index: 39.49 kg/m2), otherwise medically and surgically free, admitted electively for LSG. Intraoperatively, after a standard LSG was done a 2-3cm doudenal nodule was noted incidentally to be attached to the mesenteric surface of the first part of duodenum. The decision was to do a wedge resection of the mass followed by closing the opening using 3 interrupted stitches. Post-operative course was uneventful and patient was discharged after less than 24 hours.The histopathological examination of the duodenal nodule showed HP tissue.
Later during follow up, patient was doing well and tolerating oral intake.
Conclusion: Incidental pathology during bariatric surgery found to be around 2%, most commonly gastrointestinal stromal tumors (GISTs). We are reporting first case of incidental duodenal HP which was removed safely during LSG, further researches are recommended to look for the safety of excision of such lesion at the time of LSG .
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94592
Program Number: P166
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster