Elevation of Pancreatic Enzymes in Gallbladder Bile Associated with Heterotopic Pancreas. A Case Report and Review of the Literature

Abstract

This is the first report associating heterotopic pancreas in the gallbladder and elevated pancreatic enzymes in bile.A 60-year-old woman underwent abdominal ultrasonography at a medical check-up, revealing a nodular protrusion at the neck of the gallbladder. It seemed likely to be a lymph node, but we could not exclude the possibility of gallbladder cancer. In order to make a correct diagnosis, laparoscopic cholecystectomy was successfully performed. Pathological examination revealed heterotopic pancreatic tissue in the gallbladder wall. In addition, we detected elevated levels of amylase and lipase in gallbladder bile.Preoperative diagnosis of heterotopic pancreas in the gallbladder is difficult. However, an increase of pancreatic enzymes in gallbladder bile may potentially play an important role in the occurrence of acalculous cholecystitis and biliary cancer. We need more accumulation of cases to know the true significance of this anomaly.

View details for Web of Science ID 000213847900030

View details for PubMedID 22406610