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SMJ // Article

Case Report

Heterotopic Pancreatic Tissue in the Cystic Duct: Complicating Factor or Coexisting Pathology

Authors: Karl Mrak, MD, Thomas Eberl, MD, Jörg Tschmelitsch, MD, FACS, Cord Langner, MD

Abstract

The case of a 75-year-old female suffering from recurrent abdominal pain and nausea is presented. Ultrasound showed gallstones without inflammation of the gallbladder. The patient underwent laparoscopic cholecystectomy and her symptoms resolved. Histological examination of the operation specimen disclosed heterotopic pancreatic tissue within the cystic duct. An accurate clinical diagnosis of pancreatic heterotopia is difficult. The deep submucosal or intramural location of the lesion may hamper retrieval of representative biopsy material. Indications for surgery or endoscopic resection include symptomatic lesions as well as cases of unclear histological examination in order to distinguish pancreatic heterotopia from other tumors.

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