Year 2013 / Volume 105 / Number 1
Letter to the Editor
Upper digestive tract hemorrhage in a child with heterotopic pancreas in a gastric diverticulum

pp. 56-57

M.a José Carbonero Celis, Helena Romero Moriña, Brett Northrop Sharp, Sebastián Umbría Jiménez, Federico Argüelles Martín y José Asensio García

Abstract
The first description of heterotopic pancreas was reported by Jean-Schultz in 1727(1). It is an uncommon affliction and can be found in the upper gastrointestinal tract in 90% of all cases. Nor- mally it is subepithelial and can cause pathological changes in subjacent tissues such as fatty necrosis, inflammation and diver- ticula. Digestive hemorrhage has also been noted, especially when heterotopic pancreas is found in the gastric region (1).
Gastric diverticula, on the other hand, can be found by endoscopy in 0.01-0.11% of cases (2). They are uncommon in children and gen- erally asymptomatic, occasionally causing abdominalgia, obstruction, bleeding or perforation (2). More commonly they are congenital and located in the esophagogastric union. When they are acquired (pseu- dodiverticula) they are found in the antrum and are associated with a history of gastrointestinal disease such as peptic ulcer, cancer, pan- creatitis, an obstructive condition, or gastritis, as we suspect happened with our patient (2,3). Treatment is not required for gastric diverticula unless the patient is symptomatic, they are oversized, cause compli- cations or in order to prevent the risk of malignization (2,3). The diagnosis is confirmed by endoscopy (2), although a barium study is useful before laparoscopy, especially if the diverticula appear to be acquired. The association between heterotopic pancreas and gastric diverticula is exceptional and generally asymptomatic, even more so in children. There have only been 2 published cases that we know
of which involve pediatric patients with both malformations, but never in a patient so young (4,5). The pre-operatory diagnosis of het- erotopic pancreas is difficult regardless of imaging techniques or endoscopy, since biopsies are normally superficial, as in our case (1). We believe that the heterotopic pancreas could have weakened the gastric wall to form the diverticulum. In summary, our patient’s digestive hemorrhage was the key symptom that led to the diagnosis and treatment of both malformations.
New comment
Comments
No comments for this article
Related articles
Citation tools
M.a José Carbonero Celis, Helena Romero Moriña, Brett Northrop Sharp, Sebastián Umbría Jiménez, Federico Argüelles Martín y José Asensio García. Upper digestive tract hemorrhage in a child with heterotopic pancreas in a gastric diverticulum. 56-57


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 15 visits.
This article has been downloaded 13 times.
Share
This article has been rated by 1 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2025 y Creative Commons. The Spanish Journal of Gastroenterology