Heterotopic pancreatic tissue presenting as an unusual cause of gastric outlet obstruction in infancy: a case report.

BACKGROUND

Gastric outlet obstruction beyond the neonatal period is an extremely rare condition when other causes such as infantile hypertrophic pyloric stenosis, pyloric atresia, and antral diaphragm are ruled out. Herein, we present the case of a 2-month-old girl who presented with repeated nonbilious vomiting and showed ectopic pancreatic tissue compressing the pylorus of the stomach.

CASE PRESENTATION: A 2-month-old Caucasian girl who suffered from frequent attacks of projectile vomiting that was not resolved by medication presented to our institute. On ultrasonography, pyloric stenosis was excluded, while on gastrograffin study, there was a hugely dilated stomach with delayed passage of contrast to the distal bowel. On surgical exploration, there was an exophytic pyloric mass compressing the pyloric canal, which was completely excised. Pathological results confirmed the presence of heterotopic pancreatic tissue.

CONCLUSION

Heterotopic pancreas should always be considered as one of the rare differentials of the causes of gastric outlet obstruction in infants. Although many investigations such as sonogram and upper gastrointestinal series help in diagnosis, histology remains the definitive test in reaching the final diagnosis.