A case of single balloon endoscopy useful for diagnosis of pediatric jejunum ectopic pancreas

Abstract

An 8-year-old male was referred to our hospital for recurrent upper abdominal pain. Although blood tests and abdominal computed tomography showed no abnormal findings, barium follow-through study identified a submucosal tumor (SMT)-like lesion with a diameter of 20 mm in the proximal jejunum. Single-balloon endoscopy was performed under general anesthesia, and indicated a slightly yellowish SMT with bridging folds. Subsequent endoscopic ultrasonography revealed an echogenic mass derived from the second or third layer of intestine wall, suggesting SMT including ectopic pancreas. We injected Chinese ink into the intestinal submucosa just orally to the tumor. Histological diagnosis based on biopsied specimens was not possible. Laparoscopy-assisted partial resection of the jejunum was performed, with a final diagnosis established as jejunal ectopic pancreas (Heinrich type II). So far there have been no symptoms of recurrence.