Identification of Ectopic Pancreas in the Ileum by Capsule Endoscopy

Ectopic pancreas, an uncommon submucosal tumor in the gastrointestinal (GI) tract, is histologically similar to normal pancreatic tissue. We present a case of ectopic pancreas in the ileum. A 35-year-old man had intermittent dark bloody stool for 2 months accompanied by epigastric pain and postprandial abdominal fullness. Esophagogastroduodenoscopy and colonoscopy did not reveal any abnormalities. Capsule endoscopy revealed a small red polyp in the ileum. Abdominal computed tomography scan and small bowel barium follow-through study were not of any help. GI bleeding and abdominal discomfort were resolved after the lesion was surgically removed. Pathologic examination demonstrated pancreatic acinar cells and a secretory duct in the ileal submucosa, consistent with ectopic pancreas. Ectopic pancreas in the small intestine may be a rare cause of obscure GI bleeding. Capsule endoscopy seems to be a good, noninvasive tool for identification in the small bowel, particularly when other imaging modalities fail to detect any abnormalities. [J Formos Med Assoc 2007;106(3):240-243]