2016 Volume 52 Issue 6 Pages 1202-1207
We report the case of a 3-year-old boy who was brought to a nearby clinic for recurrent vomiting from four months earlier. His abdominal X-ray images showed gastric distension, and he was observed after oral medication. However, he had a weight loss of 3 kg during the 4-month period, and was admitted to our hospital for further examination. His abdominal ultrasonograms showed mild thickening of the muscle layer of the duodenum and pyloric ring. His upper gastrointestinal contrast examination indicated obstruction and excretion delay with a significantly expanded stomach. Although upper gastrointestinal endoscopy showed constriction at the pyloric ring, there were no abnormalities of the mucosa of the pyloric ring. He was diagnosed as having pyloric stenosis of unknown origin and surgery was performed. Intraoperative findings indicated a thickened wall of the entire circumference of the stomach antrum to the duodenum. We resected 3/4 of the circumference of the front wall of the antrum, and the antrum was reconstructed by the Heineke-Mikulicz method. The pathological diagnosis was ectopic pancreas in the pylorus. He was relieved of his symptoms and his weight had increased after the operation. Symptomatic ectopic pancreas is very rare among children, and since we were unable to remove all the pancreatic tissues completely, careful observation of the patient is necessary hereafter.
