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Heterotopes Pankreasgewebe in der Gallenblase

Diagnostik, Therapie und Verlauf einer seltenen Entwicklungsanomalie der Bauchspeicheldrüse

Heterotopic pancreas in the gallbladder

Diagnosis, therapy, and course of a rare developmental anomaly of the pancreas

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Zusammenfassung

Ektopes Pankreasgewebe ist eine seltene Entität, stellt jedoch nach dem Pankreas divisum die zweithäufigste Anomalie der Bauchspeicheldrüse dar. Es ist definiert als eigenständiges Pankreasgewebe ohne anatomische oder vaskuläre Verbindung zum Pankreashauptorgan. Die Ätiologie von ektopem Pankreasgewebe ist nicht geklärt. Die Gallenblase als Lokalisationsort von aberrierendem Bauchspeicheldrüsengewebe, wie in vorliegender Kasuistik, ist eine Rarität und wurde erstmals 1916 durch Poppi erwähnt. Die Literaturrecherche bis zum gegenwärtigen Zeitpunkt ergab weltweit nur 28 weitere publizierte Fallbeispiele. Ektopes Pankreasgewebe wird in etwa 2% aller Autopsien sowie bei einer von 500 Laparotomien als Zufallsbefund nachgewiesen. In 90% der Fälle findet man es im Magen, Duodenum oder Jejunum. Ektopes Pankreasgewebe ist meist asymptomatisch und benigne. Es bedarf daher nur bei Komplikationen, wie z. B. Passagestörung, Blutung oder maligner Entartung, einer operativen oder neuerdings auch endoskopischen Behandlung.

Abstract

Ectopic pancreas is a rare entity but the second most prevalent pancreatic anomaly. Heterotopic pancreas is defined as the presence of pancreatic tissue without any anatomic or vascular continuity with the main body of the pancreas. Its aetiology is not clearly established. In 1916, Poppi published for the first time evidence of heterotopic pancreas in the gallbladder. A review of the literature up to the present showed only 28 more cases worldwide of ectopic pancreas in the gallbladder. Aberrant pancreas is incidentally discovered in 2% of autopsies and has been estimated to occur once in every 500 upper abdominal explorations. Ninety per cent of ectopic pancreas is found in the stomach, duodenum, and jejunum. Mostly it is asymptomatic and benign. For this reason, therapy is indicated only in patients with symptoms such as pyloric obstruction, bleeding, and malignant transformation. Surgical resection or endoscopic mucosal resection as a newer method are recommended.

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Authors and Affiliations

  1. Chirurgische Klinik I, Klinikum Offenbach, Starkenburgring 66, 63069 , Offenbach

    G. Neupert & P. Appel

  2. Institut für Pathologie, Klinikum Offenbach

    S. Braun

  3. Allgemein- und Viszeralchirurgie, Herz-Jesu-Krankenhaus, Fulda

    C. Tonus

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  1. G. Neupert
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  2. P. Appel
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  3. S. Braun
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  4. C. Tonus
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Correspondence to G. Neupert.

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Neupert, G., Appel, P., Braun, S. et al. Heterotopes Pankreasgewebe in der Gallenblase. Chirurg 78, 261–264 (2007). https://doi.org/10.1007/s00104-006-1203-6

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  • DOI: https://doi.org/10.1007/s00104-006-1203-6

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