Analysis Of Clinical Features And Endoscopic Ultrasonography In The Diagnosis Of Heterotopic Pancreas

Objective:To explore the clinical features and endosonographic (EUS) features of heterotopic pancreas, the connection of sonographic features and pathological features.To Increase the awareness of heterotopic pancreas.Method:We retrospectively analyzed99heterotopic pancreas patients who underwent surgery or endoscopy dissection in the2nd Affiliated Hospital of Zhejiang University, from December2000to November2014. Patients’genders, age, clinical performances, lesion sites and detection methods were analyzed. EUS was performed in25patients with aberrant pancreas before resection. EUS features of the lesions were analyzed such as location, shape,central dimpling on the surfaces and so on. To explore EUS features with specific histologic components.Results:1. The mean age was52.5years (range,11-81),68male and31female. Heterotopic pancreas were located at many organs,75.8%were located at stomach and duodenum,86.9%were located at gastrointestinal tract. The Clinical performances were connected with the locations and pathological changes of the lesions. One lesion become cancerous.2. Endoscopic ultrasonography revealed that the lesions appease as submucosal lesions which were smaller than3cm. Heterotopic pancreas were most located at antrum(60.0%) and mucosal surfaces were smooth(84.0%). Heterotopic pancreas appears as distinct borders(72.0%), heterogenous(68.0%) hypoechoic(80.0%) lesions.The lessions originated from the second(8.0%), third(32.0%), fourth(20.0%) or more layers(40.0%) of the gastrointestinal wall. Muscularis propria became bodiness(16.0%) in some of the lesions. The characteristic EUS features of Heterotopic pancreas were the central dimpling with pit(8%) and small anechoic cystic or tubular structures within the lesions (12.0%).The margin appeared indistinct because of the lobular structure of the acinous tissue and irrugular. Acinous tissue appears as a hypoechoic image,while adipose tissue or duct tissue appears as a hyperechoic area. An anechoic area was a dilatation duct.Conclude:Heterotopic pancreas usually occurred in the stomach and duodenum, espicially in the antrum. ectopic pancreases usually have no specific symptom, but also can be appeared as gastrointestinal bleeding obstruction and so on.1.0%aberrant pancreas ware turned cancerous which suggest that heterotopic pancreas need follow-up in clinical.Endoscopic ultrasonography plays an important role in the diagnose ectopic pancreases. Heterotopic pancreas would be diagnosed When a central dimpling on the surface with duct opening or small anechoic cystic or tubular structures within the lesions was appeared. EUS features correlated with specific histologic components.