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October 1966

Heterotopic Pancreas Simulating Peptic Ulceration

Author Affiliations

From the departments of surgery, Veterans Administration Hospital, and State University of New York, Downstate Medical Center, Brooklyn.

Arch Surg. 1966;93(4):589-592. doi:10.1001/archsurg.1966.01330040053009

HETEROTOPIC pancreatic tissue has been described as tissue containing some or all of the pancreatic elements found outside the anatomic boundaries of the main pancreatic gland. This condition is being more frequently encountered with the ever increasing number of abdominal explorations; and attention is directed to its manifestations and surgical significance.

The exact pathogenesis of pancreatic heterotopia is unknown, but the thesis put forth by Cattell and Warren1 of separation from the main pancreatic mass during embryonic rotation and fusion of the dorsal and ventral anlage has gained widespread acceptance.

Incidence and Location  This condition has been estimated to occur once in every 500 explorations of the upper abdomen at the Mayo Clinic.2 It is present in 15% to 25% of all intestinal diverticula.3 Feldman and Weinberg4 found a 12.5% incidence of heterotopic pancreas in the duodenum in 265 autopsies on adults and a 15% incidence

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