Ectopic Pancreatic Tissue within the Duodenal Wall - Possible Additional Cause for Symptomatic Chronic Pancreatitis

Ectopic or heterotopic pancreatic tissue is frequently a coincidental finding since it rarely causes symptoms and, subsequently, requires treatment. However, diseases of the pancreas such as pancreatitis may also occur within the ectopic pancreatic tissue. By the mean of a case report, we describe a 47-year-old man with a medical history significant for chronic alcoholic pancreatitis for years. Attempts of conservative treatment such as medication (substitution of pancreatic enzymes, administration of analgetics) were not successful. Because of persisting complaints and problems, the patient, therefore, underwent kephal pancreatoduodenectomy according to the procedure by Kausch-Whipple, which led to complete regression of the clinical signs. Pathohistologic investigation of the surgical specimen revealed ectopic pancreatic tissue within the duodenal wall, in particular, within a duodenal duplication, which might have been also responsible for the patient's sustained complaints, signs, and symptoms.