Misdiagnosis Analysis of Gastric Ectopic Pancreas with Atypical Endoscopic Manifestations

WANG Huimin; LI Haipeng; BAI Wurina; JIN Lei; AO Wenjing; ZHAO Bo; PANG Huifang

doi:10.3969/j.issn.1002-3429.2025.15.003

Abstract：Objective To analyze the characteristics of gastric ectopic pancreas with atypical endoscopic manifestations and the causes of misdiagnosis.Methods A retrospective analysis was conducted on the clinical data of 4 patients with gastric ectopic pancreas who were misdiagnosed and underwent surgical treatment from August 2022 to August 2024.The clinical manifestations,microscopic characteristics,and differential diagnosis of this disease were summarized.Results Among the 4 patients,1 patient visited the hospital due to abdominal distension accompanied by acid reflux and belching,and 3 patients visited the hospital due to gastric masses found during physical examination.The initial diagnosis was leiomyoma in 2 patients and stromal tumor in 2 patients.The patients were treated with endoscopic mucosal dissection,endoscopic full-thickness resection or laparoscopic partial gastrectomy.Postoperative pathology confirmed the diagnosis of ectopic pancreas.The misdiagnosis period was 10 d to 6 months.The patient underwent a re-examination of gastroscopy after the operation,and the effect was favorable,achieving clinical cure.Conclusion Ectopic pancreas has no obvious specific clinical manifestations.Some gastric ectopic pancreas is difficult to distinguish from leiomyoma and stromal tumor.It is necessary to enhance clinicians'understanding and ability of differential diagnosis of this disease,and comprehensively analyze the results of gastroscopy,endoscopic ultrasonography and imaging examination results of patients,so as to reduce the misdiagnosis.