Heterotopia of the Pancreas as a Cause of Gastrointestinal Bleeding

Abstract

Heterotopia of the pancreas is an intriguing congenital anomaly defined by the presence of pancreatic tissue within other organs, devoid of vascular or ductal continuity with the primary gland. We present a case of a 67-year-old woman with a history of nonspecific gastrointestinal bleeding, manifesting as melena or hematochezia, who was admitted to our department due to a considerable amount of fresh blood in her stool and a significant drop in her blood count. Laboratory investigations indicated severe anemia, diagnostic imaging did not reveal any abnormalities aside from a hiatal sliding hernia and left colon diverticulosis. Despite conservative treatement, the patient experienced repeated enterorrhagia, followed by hemodynamic instability, ultimately necessitating urgent surgical intervention. Intraoperatively, a white lesion of about 15 mm in size was observed on the serosa of the jejunal wall, with consequent enterotomy and excision of the lesion. The following pathohistological evaluation revealed ectopic pancreatic tissue in the lamina propria and laminamuscularis of the jejunal mucosa, without significant pathological changes. Postoperative course was uneventfull, the patient was discharged for home treatment with regular follow-ups and has not experienced further gastrointestinal bleeding while her complete blood count returned within the reference range. This report illustrates the potential for severe complications arising from heterotopic pancreas, highlighting the importance of timely surgical intervention when conservative management fails. © Association of Surgeons of India 2025.