The accessory, or aberrant pancreas is a rare anomaly in the development of the gastrointestinal tract, when in addition to the main gland, another appears. The organ is located in the antrum of the gastrointestinal tract, near the wall of the stomach or 12 duodenal, ileum or small intestine, mesentery. It is considered an anomaly and appears in addition to the main organ, having the same tissues, but is not connected with it at all. How pathology manifests itself and what needs to be done, we will consider further.
What is hidden under the term “aberrant pancreas”?
Additional gland appears as a result of abnormal development. It is not worth considering its appearance as a disease, in some cases it does not manifest itself at all and hardly prevents a person from living a full life. Pathology can be detected by chance, during a laparotomy, which was prescribed for another reason. For example, when the pancreas is checked for abnormalities, with surgical intervention to remove ulcers in the stomach or intestines, surgical treatment of cholecystitis in calculous form.
Tissues of the abnormal gland and normal organ are composed of the same components. Aberrant pancreas consists of a duct that opens its lumen into the stomach or intestines. As a result of this, acute pancreatitis can develop in the additional gland. The most rare ailments include gastrointestinal bleeding.
Reasons for the development of the accessory gland
Until now, scientists have been struggling with the main question: for what reason is the double aberrant pancreatic duct formed. But there is reliable information that an anomaly occurs even in the womb, and many undesirable factors affect its development:
- unfavorable environmental background, affecting a woman during the period of bearing a baby;
- genetic pathologies;
- smoking and drinking alcohol during pregnancy;
- frequent depression and stress;
- infectious diseases that were transferred by a woman during the bearing of a baby, including syphilis, rubella, herpes and others;
- taking unwanted drugs for a pregnant woman.
Symptoms of the disease
The clinical manifestations of the presence of an aberrant pancreas depend on its size and location. If it is located in the area of the walls of the stomach, then the symptoms are very similar to the manifestation of gastritis, and if it is located in the area of the duodenum 12, then in this case the manifestations may indicate the development of an ulcer. In addition, signs may appear indicating pancreatitis, cholecystitis or appendicitis. These signs do not force the patient to consult a doctor, and the pathology may not be detected for a long time.
But in most cases, the symptoms are almost not manifested, the patient's complaints arise only with the development of complications. It:
- inflammatory processes;
- perforation of the intestinal wall or stomach;
- necrosis;
- bleeding;
- bowel obstruction.
Most often, complications appear if the additional gland is localized in the small intestine. A complication in this case is its obstruction. And if there is still inflammation in the body, then the patient may develop dyspeptic disorders, severe pain in the peritoneum.
During laboratory examination, hyperlipasemia and hyperamylasemia can be detected.
Forms of the disease
There are several forms of aberrant gland. It can be represented by:
- all existing components of the pancreas: ducts and secretory parts;
- exclusively exocrine part, which is responsible for the production of gastric juice;
- directly the endocrine part, helping to produce vital hormones that regulate blood sugar;
- adenomyosis - pancreatic tissue penetrates into the large 12 duodenal papilla (this is the opening of the duct of the gland into the duodenum 12).
Location of the aberrant gland
The aberrant pancreas can be located in the stomach and in other organs:
- the esophagus;
- the duodenum;
- the walls of the gallbladder;
- liver
- the spleen;
- small intestine;
- mesentery of the small intestine, in the fold or mucous membrane of the abdominal cavity.
How to diagnose the disease?
Pathology can be detected by various methods, it all depends on the place of its localization. If the aberrant lobule of the pancreas is located on the wall of the duodenum, in the colon or stomach, then in this case it will be easy to identify. In most cases, it is detected during a screening study. The age of patients who are most often diagnosed with the disease is 40-70 years.
Anomaly can be detected by several methods:
- Endoscopic . In this case, the gland is a large island of glandular tissue, often resembling a polyp, which is located on a wide base. Often at the top of such an island there may be an impression, which is an endoscopic sign of the aberrant gland. If a surface biopsy is taken during this study, it will be difficult to obtain accurate data.
- X-ray In this case, the anomaly can be a large formation, which is noticeable in the form of accumulation of contrast. But in this case, the mouth of the duct, which also contrasts, can be noticeable.
- Ultrasound When conducting ultrasound, additional gland can be noticed, and this is facilitated by the hypoechoic structure, the presence of additional cavities and the anechogenic duct.
- CT scan of the abdomen. This study will help identify the gland if it is located on the walls of a hollow organ. This examination helps to conduct differential diagnosis of malignant neoplasms. In the case of a tumor, there is an invasion of the organs adjacent to the peritoneum and the presence of metastases. But differential diagnosis can be difficult if the tumor is localized in the submucosal layers (leiomyoma, lipoma and myosarcoma).
Treatment of an aberrant pancreas
Patients who have been diagnosed with an abnormality believe that they will immediately have to go under the surgeon's knife. They have a reasonable question: is it worth it to remove the aberrant pancreas? It is impossible to leave it unattended, because it is dangerous in that tissue malignancy can occur. During its detection, it is urgently necessary to undergo a series of studies that will help to exclude the development of a malignant tumor. But after the final diagnosis, removal of the anomaly is recommended, but what method the surgeon chooses for this depends on the location of the gland.
If the additional organ is located superficially, then endoscopic electroexcision is recommended. If there are cysts in the organ, then in this case fenestration of cysts is performed.
Conservative treatment also works well in cases where there is no risk of cancer. Long-acting drugs are recommended, Somatostatin analogues are best suited. At the same time, symptomatic therapy is performed.
Aberrant pancreas of the antrum is not dangerous for the patient until pathological processes begin to develop. That is why, in the presence of an additional gland in a patient, treatment may not be used, but a specialist should have constant monitoring.
Complications and consequences
It is worth remembering that it is not worth completely ignoring the presence of an anomaly in the pancreas, because with any negative effect, it can easily lead to the development of such pathologies:
- pancreatitis - additional gland becomes inflamed;
- bleeding in the stomach or intestines;
- malignant neoplasm of the accessory gland or pancreas.
Prevention of complications from the accessory gland
If there is additional iron, then it is necessary to monitor its further development regularly. So that it does not cause a lot of complications, prevention is necessary:
- Follow a diet: add more easily digestible protein, fiber-rich foods to your diet. Minimum fat and nothing to enhance your appetite.
- Take drugs that help the digestive process, for example, "Creon" in the form of mini-microspheres. Capsules are easily mixed in the stomach with food and enter the intestines. This is necessary in the absence of the production of their own enzymes.
- Quitting smoking and alcohol.
If you follow the recommendations and are constantly monitored by a doctor, then the additional gland will not cause any inconvenience. In any case, constant monitoring by a specialist is necessary in order to timely identify complications and take the necessary measures.