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Wednesday, 18 May 2016

CASE 379: ECTOPIC PANCREAS TISSUE in JEJUNUM, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNA



Man 41 yo, headache, high BP, clinical looked like  pheochromocytoma.
Ultrasound detected nothing abnormal in abdomen.
CT scan of  abdomen  with CE detected small tumor in jejunum wall size of 2.5 cm, very high contrast enhancement (see CT1).


Blood test  is not  clear diagnosis.



2 weeks after CT with C E  again also detected  this tumor in same size (see CT2).


Gastro-colono endoscopy  is normal,  report  no polyp detected. Laparoendoscopy detected  this tumor is  in jejunum wall..( lap1, lap 2 , ope.. ) 






and resection  this tumor (see macro 1,2)



Surgery report is small intramural tumor of jejunum, 20 cm far from  D3, well bordered looked like ectopic pancreatic tissue. Microscopic report is  ectopic intramural jejunum pancreas tissue. 

DISCUSSION: Ectopic pancreas in jejunum is very rare, reviewing of  CT with CE  made sure  pancreas  in  normal size and structure  CT number ( HU) is 126. Comparison with  HU of  ECTOPIC  PANCREAS is 120. It  is criteria for diagnosis in suspection of  ECTOPIC PANCREAS

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1 comment :

TOAN DR said...

Case này em cho test thêm Free Metanephrine máu cho kq 12.25 pg/ml (cut off <90pg/mL) nên o nghĩ là Pheochromocytome.