Heterotopic pancreas without Meckel’s diverticulum in children as unique cause of gastrointestinal bleeding: think about it!

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Résumé

Ectopic pancreas also known as heterotopic pancreas (HP) is a rare congenital anomaly, mainly found as incidental finding
during autopsy or abdominal exploration for an other condition. Incidence rate is probably underestimated as patients are
mostly asymptomatic; otherwise, it is capable of producing symptoms depending on its location, size, often appearing in
the 4th-to-6th decades. Complications such as inflammation, obstruction, bleeding, and malignancy degeneration must be
considered. Pediatrics cases are very rare, generally concerning HP within Meckel’s diverticulum, manifesting by gastro-
intestinal bleeding and intussusception. We report a rare case of jejunum bleeding, due to an isolated HP in a 15-year-old
adolescent. Endoscopic and computed tomographic scan were normal, in particular did not found Meckel’s diverticulum.
Diagnosis and treatment have been apprehended performing a laparoscopic exploration. It is a singular location for HP, pre-
dominantly found in upper gastrointestinal tractus. So far, there have been no case reports of jejunal bleeding from ectopic
pancreas without Meckel’s diverticulum in children.

Mots-clés

Ectopic pancreas · Heterotopic pancreas · Aberrant pancreas · Meckel’s diverticulum · Gastrointestinal bleeding