El Salvador Atlas of Gastrointestinal VideoEndoscopy. A Large Database of Images and Video Clips with Cases Reported.
El Salvador Atlas of Gastrointestinal VideoEndoscopy
Heterotopic Pancreas with large central hole. Heterotopic Pancreas, due to the hole, as the diameter is not usual in the heterotopic pancreas, some biopsies were obtain from the submucosa which was demonstrated by histology that is a pancreas tissue. Heterotopic pancreatic tissue, also termed a "pancreatic rest," can be found in the stomach, duodenum, or jejunum. Typically, these rests are asymptomatic, but abdominal pain, nausea, vomiting, and rarely bleeding have been attributed to rests located in the stomach. These lesions typically appear as 2- to 4-cm submucosal masses in the prepyloric region, and it is not unusual that central umbilication is noted. The nodules are fi rm and may have a yellow appearance. Endoscopic ultrasound will show a heterogenous submucosal mass with a pancreatic duct remnant.

Video Endoscopic Sequence 1 of 6.

Heterotopic Pancreas with large central hole.

 Heterotopic Pancreas, due to the hole, as the diameter is
 not usual in the heterotopic pancreas, some biopsies were
 obtain from the submucosa which was demonstrated by
 histology that is a pancreas tissue.

 Heterotopic pancreatic tissue, also termed a “pancreatic
 rest,” can be found in the stomach, duodenum, or jejunum.
 Typically, these rests are asymptomatic, but abdominal
 pain, nausea, vomiting, and rarely bleeding have been
 attributed to rests located in the stomach. These lesions
 typically appear as 2- to 4-cm submucosal masses in the
 prepyloric region, and it is not unusual that central
 umbilication is noted. The nodules are firm and may have a
 yellow appearance. Endoscopic ultrasound will show a
 heterogenous submucosal mass with a pancreatic duct
 remnant.

 For more endoscopic details download the video clips by
 clicking on the endoscopic images, wait to be downloaded
 complete then press Alt and Enter; thus you can observe
 the video in full screen.

 All endoscopic images shown in this Atlas contain
 video clips.           

Heterotopic pancreas is an uncommon but not an exceedingly rare finding. Most of the time, the heterotopic pancreas is usually small (1 cm to 3 cm in size) and located in the antrum. Pancreatic rests are often discovered incidentally . Despite the observation that most cases of heterotopic pancreas do not cause problems, the condition has been reported to lead to symptoms from inflammation, obstruction, or even malignant transformation. Smaller rests have been removed using endoscopic techniques, primarily to secure a diagnosis, as the smaller tumors are often asymptomatic.

Video Endoscopic Sequence 2 of 6.

 Heterotopic pancreas is an uncommon but not an
 exceedingly rare finding. Most of the time, the heterotopic
 pancreas is usually small (1 cm to 3 cm in size) and located
 in the antrum. Pancreatic rests are often discovered
 incidentally.

 Despite the observation that most cases of heterotopic
 pancreas do not cause problems, the condition has been
 reported to lead to symptoms from inflammation,
 obstruction, or even malignant transformation. Smaller
 rests have been removed using endoscopic techniques,
 primarily to secure a diagnosis, as the smaller tumors are
 often asymptomatic.

The biopsies were obtain from the submucosa , Although malignant transformation has been reported, this appears to be uncommon enough that recommendations on follow up probably should be based on symptoms. With the abuse of alcohol has been reported "gastric pancreatitis."

Video Endoscopic Sequence 3 of 6.

The biopsies were obtain from the submucosa

 Although malignant transformation has been reported, this
 appears to be uncommon enough that recommendations on
 follow up probably should be based on symptoms.

 With the abuse of alcohol has been reported "gastric pancreatitis."

Low power view of gastric heterotopic pancreas.

Video Endoscopic Sequence 4 of 6.

Low power view of gastric heterotopic pancreas
( Acinar pancratic tissue at the left.

Video Endoscopic Sequence 5 of 6.

 Acinar pancratic tissue at the left
High power detail of the heterotopic pancreas.

Video Endoscopic Sequence 6 of 6.

High power detail of the heterotopic pancreas
PancreasAbarrarnte. The majority of the patients are asymptomatic and the lesion is diagnosed incidentally. Heterotopic pancreas is defined as pancreatic tissue outside the boundaries of the pancreas that lacks anatomic and vascular continuity to this organ. Heterotopic pancreas is a relatively infrequent lesion. The pathogenesis of this lesion is unknown; it is believed to arise during embryonic development of the gastrointestinal tract. The normal pancreas is derived from several evaginations originating from the wall of the primitive duodenum. During embryogenesis, if one or more evaginations remain in the wall of the bowel, then it may be carried away from the remainder of the gland by the developing gastrointestinal tract and may give rise to heterotopic pancreas.

Heterotopic Pancreas

 The majority of the patients are asymptomatic and the
 lesion is diagnosed incidentally.

 Heterotopic pancreas is defined as pancreatic tissue
 outside the boundaries of the pancreas that lacks anatomic
 and vascular continuity to this organ. Heterotopic pancreas
 is a relatively infrequent lesion.

 The pathogenesis of this lesion is unknown; it is believed to
 arise during embryonic development of the gastrointestinal
 tract. The normal pancreas is derived from several
 evaginations originating from the wall of the primitive
 duodenum. During embryogenesis, if one or more
 evaginations remain in the wall of the bowel, then it may be
 carried away from the remainder of the gland by the
 developing gastrointestinal tract and may give rise to
 heterotopic pancreas.
Pancreatic Heterotopia. Antral nodule with typically central depression and intact overlying, antral mucosa, the submucosa is the most frequent location, both exocrine and endocrine pancreatic tissue may comprise the lesion. The most distinctive heterotopic lesions occurs in the antrum. Ectopic pancreas generally has a typical apical dimple characteristic of this lesion. A rudimentary ductal system may empty into this depression.

Pancreatic Heterotopia.

 Antral nodule with typically central depression and intact
 overlying, antral mucosa, the submucosa is the most
 frequent location, both exocrine and endocrine pancreatic
 tissue may comprise the lesion.
 The most distinctive heterotopic lesions occurs in the
 antrum. 
 Ectopic pancreas generally has a typical apical dimple
 characteristic of this lesion. A rudimentary
 ductal system may empty into this depression.