Gastric Ectopic Pancreas: A Pediatric Case Report.

An ectopic pancreas is a congenital anomaly in which pancreatic glandular tissue is found outside its normal anatomical location. Specifically, while it can occur anywhere along the gastrointestinal tract, its presence in the stomach is relatively rare in children and is often asymptomatic, typically discovered incidentally. Our case involves a six-year-old child who underwent an esophagogastroduodenoscopy due to the suspicion of celiac disease in the context of iron-deficiency anemia that did not respond to oral iron therapy, despite the absence of associated clinical symptoms and a normal physical examination. The esophagogastroduodenoscopy incidentally revealed a well-defined, 5-mm submucosal nodular lesion in the prepyloric region, with a central depression, characteristic of an ectopic gastric pancreas. Histological examination of the duodenal biopsies confirmed coeliac disease. In contrast, the biopsy of the lesion showed no evidence of neoplasia and was considered normal. Our case highlights the diagnostic challenge posed by normal histology in the context of suspected gastric ectopic pancreas, as superficial biopsies may be non-contributory due to its submucosal location. It also underscores the importance of recognizing the typical endoscopic features to avoid misdiagnosis and unnecessary invasive procedures in pediatric patients.