A case of an aberrant pancreas with pancreatitis

Abstract

We report an unusual case of an aberrant pancreas with calcifications in the mesentery recognized in abdominal computed tomography (CT). A 54 year-old man admitted for abdominal pain on September 25, 1996. was found in CT to have a mass lesion of the small intestine containing scattered coarse calcifications. Follow-up CT showed a reduction in size, and abdominal pain improved 2 weeks later. Radiological enteroclysis failed to disclose abnormal findings. He was referred to our hospital for relapsing abdominal pain necessitating laparotomy on November 7, 1996. CT showed the lesion had grown as large as at the first CT. Laparotomy showed the mass in the mesentery located 50 cm on the anal side from Treitz's ligament, necessitating jejunectomy. The specimen revealed a duct with an orifice on the jejunal mucosa connecting the mass with the jejunum. Histochemical and immunohistochemical stains in addition to H.E. staining showed that the mass consisted of acini, islet cells, and ductal system, leading to diagnosis of a group I aberrant pancreas according to Heinrich's classification. It also showed neutrophil infiltration in the calcified aberrant pancreas, suggesting acute chronic pancreatitis responsible for abdominal pain.