[Endoscopic diagnosis of a gastric heterotopic pancreas and esophageal atresia: an incidental association?].
Heterotopic or aberrant pancreas is a rare congenital anomaly, usually asymptomatic. The preoperative diagnosis is difficult but most cases of gastric ectopic pancreas have a unique appearance that often makes possible a diagnosis in the absence of histologic confirmation. A well-delineated submucosal, firm mass with central umbilication is characteristic of gastric ectopic pancreas. To the best of our knowledge, the association of esophageal atresia and gastric heterotopic pancreas has never been reported previously.


METHODS
We report two cases of heterotropic pancreas associated with esophageal atresia. Both diagnoses were incidental findings and concerned children operated on at birth for esophageal atresia. Although a definitive diagnosis is histologic, the endoscopic appearance made it possible to maintain this diagnosis.


CONCLUSIONS
Some symptoms have been attributed to ectopic pancreas, and malignant degeneration has been reported in adults. Management continues to be debated: some authors recommend surgical resection while others, as we do, prefer initial therapeutic abstention.
Pouessel
G
G
Unité de gastroentérologie, hépatologie et nutrition, clinique de pédiatrie, hôpital Jeanne-de-Flandre, 2, avenue Oscar-Lambret, 59037 Lille, France.
Michaud
L
L
Pierre
M H
MH
Guimber
D
D
Sfeir
R
R
Robert
Y
Y
Gottrand
F
F
Turck
D
D
D001706:Biopsy; D002675:Child, Preschool; D002828:Choristoma / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004933:Esophageal Atresia / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D004945:Esophagoscopy / Q000379:methods; D005773:Gastroscopy / Q000379:methods; D006801:Humans; D008297:Male; D010179:Pancreas; D013272:Stomach Diseases / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014463:Ultrasonography