AB142. SOH22ABS059. Oesophageal pancreatic heterotopic in absence of oesophageal mass or dysphagia

Background: It is a rare congenital condition where pancreatic tissue is located elsewhere in the gastrointestinal tract without any connection to the solid organ itself. This is usually and incidental finding in patients for surgery or other procedures such oesophago-gastro-duodenoscopy (OGDs). Heterotopic pancreas (HP) is a congenital abnormality that represents ectopic pancreatic tissue that does not have anatomic, vascular, or ductal continuity. The prevalence of HP is 0.55% to 13.7% on autopsy, 0.2% to 0.5% of abdominal operations, and 0.9% of gastrectomies. It is commonly found in the stomach, duodenum, and proximal jejunum. Only 15 cases have been reported in the medical literature regarding involvement of the esophagus.

Methods: Our case was a 38 years male with past medical history significant for gastroesophageal reflux, Barrett’s oesophagus diagnosed on and oesophagogastroscopy (OGS) in 2018. No other significant medical or surgical history. Endoscopic evaluation was also performed as a part of the gastroesophageal reflux workup. No masses or lesions were visualized but oesophagitis and Barrett’s oesophagus.

Results: Two biopsies were taken from the third lower part of oesophagus and histology shows features of reflux oesophagitis and chronic inflammation, a nodule of pancreatic heterotopias is present with in the glandular mucosa.

Conclusions: There is no discrete clinical syndrome associated with heterotopic pancreatic tissue however symptoms tend to manifest depending on the anatomical location and size of the lesion. In our case, symptoms were treated conservatively and successfully with a proton pump inhibitor (PPI).

Keywords: Oesophageal pancreatic heterotopic; endoscopy findings; gastroesophageal reflux; Barrett’s oesophagus; esophageal