title: Elevation of pancreatic enzymes in gallbladder bile associated with heterotopic pancreas. A case report and review of the literature.
abstract: BACKGROUND
  This is the first report associating heterotopic pancreas in the gallbladder and elevated pancreatic enzymes in bile.
  
  
  METHODS
  A 60-year-old woman underwent abdominal ultrasonography at a medical check-up, revealing a nodular protrusion at the neck of the gallbladder. It seemed likely to be a lymph node, but we could not exclude the possibility of gallbladder cancer. In order to make a correct diagnosis, laparoscopic cholecystectomy was successfully performed. Pathological examination revealed heterotopic pancreatic tissue in the gallbladder wall. In addition, we detected elevated levels of amylase and lipase in gallbladder bile.
  
  
  CONCLUSIONS
  Preoperative diagnosis of heterotopic pancreas in the gallbladder is difficult. However, an increase of pancreatic enzymes in gallbladder bile may potentially play an important role in the occurrence of acalculous cholecystitis and biliary cancer. We need more accumulation of cases to know the true significance of this anomaly.
authors.affiliation: Department of Digestive Surgery, Toranomon Hospital, Tokyo, Japan. asahi.sato39@gmail.com
authors.forename: Asahi
authors.initials: A
authors.lastname: Sato
authors.forename: Masaji
authors.initials: M
authors.lastname: Hashimoto
authors.forename: Kazunari
authors.initials: K
authors.lastname: Sasaki
authors.forename: Masamichi
authors.initials: M
authors.lastname: Matsuda
authors.forename: Goro
authors.initials: G
authors.lastname: Watanabe
mesh_terms: D000681:Amylases / Q000378:metabolism*; D002828:Choristoma / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D005705:Gallbladder Diseases / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D008049:Lipase / Q000378:metabolism*; D008875:Middle Aged; D010179:Pancreas
chemical_list: D008049:Lipase; D000681:Amylases