Ali ŞENKAYA, Ferit ÇELİK, İlkçe AKGÜN, Fatih TEKİN, Nevin ORUÇ, Ahmet AYDIN

Ektopik Pankreas Olgularının Endosonografik Özelliklerinin Retrospektif Tek Merkez Değerlendirilmesi

GİRİŞ ve AMAÇ: Ektopik pankreas, normal pankreas dışında kalan pankreas dokusudur. Bu çalışmanın amacı, endoskopik ultrason incelemesi ile ektopik penakreas olduğu düşünülen lezyonların sonografik özelliklerinin belirlenmesidir. YÖNTEM ve GEREÇLER: Çalışmamız Mart 2014–Mart 2020 tarihleri arasında endoskopik ultrason incelemesi ile ektopik pankreas tanısı konulan 53 olgunun retrospektif tek merkezli değerlendirilmesini içermektedir. BULGULAR: Çalışmamızdaki olguların 32 (%60,4)’si kadın ve yaş ortalaması 44,7 ± 12,1 yıl saptanmıştır. Lezyonların 37 (%69,8)’si antrum büyük kurvaturda, 10 (%18,9)’u antrum posterior, üçü (%5,7) korpus, ikisi (%3,8)’bulbusta saptanmıştır. Endoskopik ultrason incelemesinde, lezyonların tamamı heterojen paternde, 52 (%98,1)’si hipoekoik görünümde, 45 (%85)’inin sınırları düzenli olduğu ve 45 (%85)’inde de santral umbilikasyon varlığı saptanmıştır. Lezyonların en sık (%90,6) submukoza yerleşimli olduğu görülmüştür. Lezyonların uzun aks ortalaması 10,7 ± 3,5 mm, kısa aks ortalaması 4,8 ± 1 mm ve uzun aks / kısa aks oranı 2,4 ± 0,9 olarak saptanmıştır. Umbilikasyon varlığı ile lezyonların boyutları ve boyut oranları arasında anlamlı farklılık saptanmamıştır (sırasıyla p = 0,550; 1,00 ve 0,583). TARTIŞMA ve SONUÇ: Endoskopik ultrason incelemede; 2cm’den küçük, submukozal orijinli, heterojen ve hipoekoik paternli, anekoik kanal benzeri yapıların olduğu, santral umbilikasyonun eşlik ettiği, uzun aks / kısa aks oranı 1,5’den büyük olan subepitelyal lezyonların saptanması durumunda ektopik pankreas teşhisi ön planda tutulmalıdır.

Anahtar Kelimeler:

Ektopik pankreas, endoskopik ultrasonografi, subepitelyal lezyon

Retrospective Single Center Evaluation of Endosonographic Features of Ectopic Pancreas Cases

INTRODUCTION: Ectopic pancreas is defined as pancreatic tissue located outside the normal pancreas. The aim of the present study was to determine the sonographic characteristics of lesions considered as ectopic pancreas via endoscopic ultrasonography examination. METHODS: This retrospective single-center study included 53 patients diagnosed with ectopic pancreas by endoscopic ultrasonography between March 2014 and March 2020. RESULTS: In the study, 32 (60.4%) patients were female and mean age was 44.7 ± 12.1 years. Further, 37 (69.8%) lesions were detected at the antrum greater curvature side, 10 (18.9%) at the antrum posterior wall, three (5.7%) at the corpus, two (3.8%) at the bulbus. EUS examination revealed that all lesions exhibited a heterogeneous pattern, 52 (98.1%) lesions had a hypoechoic appearance, 45 (85%) lesion borders were regular, and 45 (85%) showed central umbilication. The lesions were most frequently located in the submucosa (90.6%). The mean long axis was 10.7 ± 3.5 mm, mean short axis was 4.8 ± 1.0 mm, and long/short axis ratio was 2.4 ± 0.9. No significant difference was observed between the dimensions and size ratios of lesions and the presence or absence of umbilication (p = 0.550; 1.000 and 0.583, respectively). DISCUSSION AND CONCLUSION: In cases where the endoscopic ultrasonography examination revealed subepithelial lesions of submucosal origin that are <2 cm in size, exhibiting a heterogeneous pattern and hypoechoic appearance, anechoic duct-like structures, and a long/short axis ratio of >1.5 along with central umbilication, the diagnosis of ectopic pancreas should be prioritized.

Keywords:

Ectopic pancreas, endoscopic ultrasonography, subepithelial lesion,

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