Analysis of CT imaging features and causes of miss diagnosis of ectopic pancreas based on endoscopy

Abstract

Objective To explore the imaging manifestations of ectopic pancreas based on endoscopic findings in order to find out the causes of miss diagnosis and to improve the diagnostic accuracy. Methods The clinical and CT imaging data of ectopic pancreas patients who underwent CT examination and confirmed by endoscopy and pathology microscopy at Air Force Medical Center from July 2018 to March 2023 were collected. Their imaging characteristics were analyzed according to the endoscopic findings and the miss diagnosis was analyzed. Results There were 13 patients with ectopic pancreas and 3 of them had no obvious symptoms. Ten patients presented with gastrointestinal symptoms, including epigastric discomfort and pain, incomplete obstruction, and melena. Lesion sites: 8 cases were located in the gastric antrum and 5 cases were located in the small intestine. In this group, two patients showed apical erosions and glandular opening-like depressions on endoscopic results, but only one patient showed a “ductal sign” shown by CT scanning. None of the 13 patients in this group made ectopic pancreatic diagnosis on imaging, of which 4 were diagnosed as thickening of the gastrointestinal tract wall, 3 were diagnosed as gastrointestinal stromal tumor, 3 were diagnosed as benign tumors and 3 had no obvious abnormalities. Conclusions The imaging diagnosis of ectopic pancreas should be made by closely combinating with the results of endoscopy to improve the accuracy of imaging diagnosis. CT is of great significance for the diagnosis of ectopic pancreas, and adequate preparation before gastrointestinal examination is an important step to avoid misdiagnosis.

Keywords

• gastrointestinal tract|ectopic pancreas|ct|digestive endoscopy|miss diagnosis