[Heterotopic accessory pancreas in surgical pathology: review of 23 years experience].
BACKGROUND
The abnormal presence of the pancreatic tissue in other digestive organs is rare but sometimes is the cause of some surgical diseases.


METHODS
This retrospective study is focussed on heterotopic pancreas cases diagnosed in 2nd Surgical Clinic of "Sf. Spiridon" Emergency Hospital from Iaşi between Jan. 1986 and Dec. 2008.


RESULTS
22 patients (15 males/68.2% and 7 females/31.8%) aged between 23 and 76 years were grouped in A group--clinical symptomatic cases (3 patients/13.6%), group B--coincidental cases (17 patients/77.3%) and group C--incidental cases (2 patients/9%). Group A patients presented with obstructing prepyloric polypoid tumors and recquired antrectomy and gastroduodenal anastomosis. 13 patients of group B (76.4%) recquired surgery for pyloroduodenal stenosis and in 4 cases of this group with severe upper-GI bleeding, a subtotal gastric resection (3 patients) or antrectomy (1 case) was performed. In group C patients jejunal HP was histopathologically diagnosed during extensive intestinal resection for colonic malignancies (ascendant colonic and transverse colonic cancers) with jejunal invasion. HP cases were categorized as type I in 40.9% cases (ducts, acini and pancreatic islets), type II in 45.4% cases (ducts and acini) and type III (exclusively with ducts) in 13.6% cases. In 76% patients HP was localized in mucosal and submucosal layers, in 16% intramucosal and in 8% in subserous layer.


CONCLUSIONS
HP is most often an unexpected symptomless coincidental diagnosis during gastrointestinal surgical diseases.
Tăranu
T
T
U.M.E Gr. T. Popa Iasi, Spitalul Clinic Judetean de Urgente "Sf. Spiridon", Clinica II Chirurgie, B-dul Indepenenţei 1, Iaşi, Romania, 700111. traiantaranu@yahoo.com
Vintilă
D
D
Neacşu
N
N
Popa
P
P
Luncă
C
C
Crumpei
F
F
Rădulescu
D
D
Georgescu
St O
SO
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002828:Choristoma / Q000150:complications / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D005260:Female; D017219:Gastric Outlet Obstruction / Q000175:diagnosis / Q000209:etiology / Q000473:pathology* / Q000601:surgery*; D006396:Hematemesis / Q000209:etiology; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D010179:Pancreas; D011707:Pyloric Stenosis / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome