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Heterotopic Pancreas in the Stomach: CT Findings¹

¹ From the Departments of Radiology (J.S.C., K.S.S., S.T.K., J.W.K., C.J.S.), Surgery (S.M.N.), and Pathology (D.Y.K.), Chungnam University Hospital Daesa-dong 640, Joong-Ku, Taejon 301-040, Korea; the Department of Radiology, Sun General Hospital, Taejon, Korea (H.Y.K.); and the Department of Radiology, Chunnam University Hospital, Kwangju, Korea (H.K.K.). Received August 27, 1999; revision requested October 7; revision received January 19, 2000; accepted February 7. Address correspondence to J.S.C. (e-mail: jscho@cnuh.chungnam.ac.kr).

PURPOSE: To describe the computed tomographic (CT) findings of heterotopic pancreas in the stomach.

MATERIALS AND METHODS: CT findings in 12 patients with heterotopic pancreas in the stomach were reviewed. Surgical resection (n = 11) or endoscopic excision (n = 1) was performed in cases of symptomatic heterotopic pancreas (n = 4), suspected submucosal tumors (n = 7), and gastric carcinoma (n = 1). Seven patients underwent helical CT with water as an oral contrast agent; five underwent nonhelical CT with water-soluble contrast material.

RESULTS: Nine heterotopic pancreata were in the antrum and one each was in the body, fundus, and perigastric fat. Seven lesions were on the greater curvature aspect; five, on the lesser curvature aspect. Common CT findings were well-defined oval or round masses with smooth or serrated margins in the gastric antral wall. Four of the seven lesions in which helical CT was performed enhanced similarly to normal pancreas. Preoperatively, CT depicted 11 of the 12 lesions, but CT findings were interpreted correctly as heterotopic pancreas in only two; the remaining 10 were misinterpreted as other lesions. Atypical findings were cystic dilatation of heterotopic pancreatic duct in two, unusual location in the fundus or perigastric fat in two, and malignant transformation in one.

CONCLUSION: CT findings of heterotopic pancreas in the stomach appear to be nonspecific for diagnosis, except for location.

Index terms: Pancreas, heterotopic (new), 72.314 • Stomach, abnormalities, 72.314 • Stomach, CT, 72.1211 • Stomach, neoplasms, 72.312

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