title: Heterotopic ileal pancreas with lipoma and coexisting fibromatosis associated with a rare case of gastrointestinal bleeding. A case report and review of the literature.
abstract: BACKGROUND
  The development of pancreatic tissue outside the confines of the main gland represents a congenital abnormality referred to as heterotopic pancreas. This is a rare pathological and surgical entity which remains mostly asymptomatic.
  
  
  METHODS
  We present the case of a 28-year-old male, who was admitted to hospital because of a history of blood in bowel movements. After a normal gastroscopy and colonoscopy, Tc99m-tagged red blood cells scintigraphy showed enrichment in the right lower abdomen. At double-balloon endoscopy, a intraluminal polypoid mass 8 cm in diameter was revealed 120 cm from the ileocecal valve. The initial macroscopic diagnosis was a gastrointestinal stromal tumor. During surgery, the diagnosis of heterotopic pancreas with lipoma and fibromatosis was made. To our knowledge this is the first case of ileal heterotopic pancreatic tissue and lipoma described to date in the literature.
  
  
  CONCLUSIONS
  Ileal heterotopic pancreas is a rare entity with potentially life-threatening complications, local excision being the appropriate indicated treatment.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Charité Virchow Clinic, Berlin, Germany. panagiotis.fikatas@charite.de
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Fikatas
authors.forename: Igor Maximilian
authors.initials: IM
authors.lastname: Sauer
authors.forename: Martina
authors.initials: M
authors.lastname: Mogl
authors.forename: Charalambos
authors.initials: C
authors.lastname: Menenakos
authors.forename: Andreas
authors.initials: A
authors.lastname: Luegering
authors.forename: Guido
authors.initials: G
authors.lastname: Schumacher
authors.forename: Jan
authors.initials: J
authors.lastname: Langrehr
authors.forename: Peter
authors.initials: P
authors.lastname: Neuhaus