Modified endoscopic mucosal resection of gastric heterotopic pancreas: Report of two cases

SummaryHeterotopic pancreas is a congenital anomaly characterized by the presence of ectopic pancreatic tissue far from the pancreas. The treatment of heterotopic pancreas may include expectant observation, endoscopic resection, or surgery. The aim of this study was to describe the technique of cap-assisted endoscopic mucosal resection for the management of heterotopic pancreas of the stomach. Two patients, a 41-year-old woman and a 31-year-old man, were referred to us for the management of gastric subepithelial lesions. Endoscopic ultrasound was used in the female patient to disclose two small hypoechoic lesions arising from the submucosal layer. Cap-assisted endoscopic mucosal resection was performed in both patients without complications. Histopathological examination of the resected specimens showed heterotopic pancreatic tissue in the submucosal layer. Our technique is a suction, snaring, and cut method. This method does not need a special cap with a shallow circumferential lip on the inside and the snare does not need to be pre-looped. This technique allowed a histopathological confirmation of the suspected diagnosis in both patients.