Journal of Medical Ultrasonics

, Volume 42, Issue 2, pp 277–280 | Cite as

Endoscopic ultrasonography of duodenal aberrant pancreas: comparison with histology after endoscopic resection

  • Takashi Watanabe
  • Kunihiko Aoyagi
  • Yoshitaka Tomioka
  • Hideki Ishibashi
  • Satoshi Nimura
  • Shotaro Sakisaka
Case Report


We present the case of a 45-year-old man with an aberrant pancreas in the duodenum. He was referred to our hospital for gastric cancer screening. On upper gastrointestinal endoscopy, a submucosal tumor was noted in the second portion of the duodenum; it was 10 mm in diameter, with a smooth surface and bridging fold. Endoscopic ultrasonography (EUS) showed a hypoechoic lesion with small anechoic areas located in the third sonographic layer of the duodenum wall. To confirm the exact diagnosis, endoscopic resection was performed. The histological diagnosis was aberrant pancreas, Heinrich type II. The hypoechoic lesion and anechoic areas on EUS findings clearly corresponded with pancreatic acinus cells and duct dilation on histological findings, respectively. EUS findings are useful to diagnosis a duodenal aberrant pancreas that has ductal structures.


Aberrant pancreas Duodenum Endoscopic ultrasonography Endoscopic resection 


Conflict of interest


Ethical standard

All procedures were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Declaration of Helsinki of 1975, as revised in 2008 (5). Informed consent was obtained from the patient. Additional informed consent was obtained from the patient regarding the identifying information that is included in this article.


  1. 1.
    Rosai JR. Pancreas and periampullary region. In: Rosai JR, editor. Ackerman’s surgical pathology. St Louis: CV Mosby; 1989. p. 757–88.Google Scholar
  2. 2.
    Lai EC, Tompkins RK. Heterotopic pancreas. Review of a 26 year experience. Am J Surg. 1986;151:697–700.CrossRefPubMedGoogle Scholar
  3. 3.
    de Castro Barbosa JJ, Dockerty MB, Waugh JM. Pancreatic heterotopia; review of the literature and report of 41 authenticated surgical cases, of which 25 were clinically significant. Surg Gynecol Obstet. 1946;82:527–42.Google Scholar
  4. 4.
    Mekky MA, Yamao K, Sawaki A, et al. Diagnostic utility of EUS-guided FNA in patients with gastric submucosal tumors. Gastrointest Endosc. 2010;71:913–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Matsumoto S, Miyatani H, Yoshida Y. Endoscopic submucosal dissection for duodenal tumors: a single-center experience. Endoscopy. 2013;45:136–7.CrossRefPubMedGoogle Scholar
  6. 6.
    Kojima T, Takahashi H, Parra-Blanco A, et al. Diagnosis of submucosal tumor of the upper GI tract by endoscopic resection. Gastrointest Endosc. 1999;50:516–22.CrossRefPubMedGoogle Scholar
  7. 7.
    Hunt GC, Smith PP, Faigel DO. Yield of tissue sampling for submucosal lesions evaluated by EUS. Gastrointest Endosc. 2003;57:68–72.CrossRefPubMedGoogle Scholar
  8. 8.
    Yoshikane H, Tsukamoto Y, Niwa Y, et al. Carcinoid tumors of the gastrointestinal tract: evaluation with endoscopic ultrasonography. Gastrointest Endosc. 1993;39:375–83.CrossRefPubMedGoogle Scholar
  9. 9.
    Palazzo L, Landi B, Cellier C, et al. Endosonographic features predictive of benign and malignant gastrointestinal stromal cell tumours. Gut. 2000;46:88–92.CrossRefPubMedCentralPubMedGoogle Scholar
  10. 10.
    Wei R, Wang QB, Chen QH, et al. Upper gastrointestinal tract heterotopic pancreas: findings from CT and endoscopic imaging with histopathologic correlation. Clin Imaging. 2011;35:353–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Shim CS, Hong SJ, Cho YD, et al. Endoscopic ultrasonographic features of gastric aberrant pancreas without central dimpling. Ultrasound Med Biol. 1997;23:42.CrossRefGoogle Scholar
  12. 12.
    Park SH, Kim GH, do Park Y, et al. Endosonographic findings of gastric ectopic pancreas: a single center experience. J Gastroenterol Hepatol. 2011;26:1441–6.PubMedGoogle Scholar
  13. 13.
    Matsushita M, Hajiro K, Okazaki K, et al. Gastric aberrant pancreas: EUS analysis in comparison with the histology. Gastrointest Endosc. 1999;49:493–7.CrossRefPubMedGoogle Scholar
  14. 14.
    von Heinrich H. Ein Beitrag zur Histologie des sogen: akzessorischen Pankreas. Virchows Arch A Pathol Anat Histopathol. 1909;198:392–401.CrossRefGoogle Scholar

Copyright information

© The Japan Society of Ultrasonics in Medicine 2014

Authors and Affiliations

  • Takashi Watanabe
    • 1
  • Kunihiko Aoyagi
    • 1
  • Yoshitaka Tomioka
    • 1
  • Hideki Ishibashi
    • 1
  • Satoshi Nimura
    • 2
  • Shotaro Sakisaka
    • 1
  1. 1.Department of Gastroenterology and MedicineFukuoka University School of MedicineFukuokaJapan
  2. 2.Department of PathologyFukuoka University School of MedicineFukuokaJapan

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