{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T23:35:48Z","timestamp":1781566548615,"version":"3.54.5"},"reference-count":28,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Pancreatic heterotopy is a rare entity defined as the presence of abnormally located pancreatic tissue without any anatomical or vascular connection to the normal pancreas. Heterotopic pancreatic tissue can be found in various regions of the digestive system, such as the stomach, duodenum, and upper jejunum, with the less commonly reported location being the gallbladder. Gallbladder pancreatic heterotopia can be either an incidental finding or diagnosed in association with cholecystitis. Pancreatitis of the ectopic tissue has also been described. In this context, we report three cases of heterotopic pancreatic tissue in the gallbladder with different types of pancreatic tissue according to the Heinrich classification. One patient was a 24-year-old male who presented with acute pancreatitis symptoms and an ultrasonographical detected mass in the gallbladder, which proved to be heterotopic pancreatic tissue. The other two cases were female patients aged 24 and 32, respectively, incidentally diagnosed on histopathological examination after cholecystectomy for symptomatic cholelithiasis. Both cases displayed chronic cholecystitis lesions; one of them was also associated with low grade dysplasia of the gallbladder. Although a rare occurrence in general, pancreatic heterotopia should be acknowledged as a possible incidental finding in asymptomatic patients as well as a cause for acute cholecystitis or pancreatitis.<\/jats:p>","DOI":"10.3390\/medicina59081407","type":"journal-article","created":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T09:06:44Z","timestamp":1690880804000},"page":"1407","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Gallbladder Pancreatic Heterotopia\u2014The Importance of Diagnostic Imaging in Managing Intraoperative Findings"],"prefix":"10.3390","volume":"59","author":[{"given":"Crengu\u0163a Sorina","family":"\u015eerboiu","sequence":"first","affiliation":[{"name":"Department of Cellular, Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Radiology and Medical Imaging, University Emergency Hospital Bucharest, 050098 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4667-5631","authenticated-orcid":false,"given":"C\u0103t\u0103lin","family":"Aliu\u0219","sequence":"additional","affiliation":[{"name":"Surgical Department IV, University Emergency Hospital Bucharest, 050098 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3784-7355","authenticated-orcid":false,"given":"Adrian","family":"Dumitru","sequence":"additional","affiliation":[{"name":"Pathology Department, University Emergency Hospital Bucharest, 050098 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5695-9208","authenticated-orcid":false,"given":"Dana","family":"\u021a\u0103poi","sequence":"additional","affiliation":[{"name":"Pathology Department, University Emergency Hospital Bucharest, 050098 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Costache","sequence":"additional","affiliation":[{"name":"Pathology Department, University Emergency Hospital Bucharest, 050098 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana Elena","family":"Nica","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, University Emergency Hospital Bucharest, 050098 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mih\u0103ilescu","family":"Alexandra-Ana","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Foisor Hospital Bucharest, 021382 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0112-3494","authenticated-orcid":false,"given":"Iulian","family":"Antoniac","sequence":"additional","affiliation":[{"name":"Department of Metallic Materials Sciense and Physical Metallurgy, Faculty of Materials Science and Engineering, University Politehnica of Bucharest, 060042 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Gr\u0103dinaru","sequence":"additional","affiliation":[{"name":"Department of General Surgery, County Hospital Ilfov, 050474 Bucharest, Romania"},{"name":"Titu Maiorescu University of Medicine and Pharmacy, 031593 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.1007\/s00268-005-0669-6","article-title":"Diagnosis and treatment of gastric heterotopic pancreas","volume":"30","author":"Ormarsson","year":"2006","journal-title":"World J. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1097\/00007611-198810000-00016","article-title":"Pancreatic heterotopia: A reappraisal and clinicopathologic analysis of 32 cases","volume":"81","author":"Pang","year":"1988","journal-title":"South. Med. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"142","DOI":"10.4103\/2229-516X.106360","article-title":"Heterotopic pancreas in gall bladder associated with chronic cholecystolithiasis","volume":"2","author":"Elhence","year":"2012","journal-title":"Int. J. Appl. Basic Med. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/j.clinimag.2007.05.007","article-title":"Pancreatitis in initially occult gastric heterotopic pancreas","volume":"31","author":"Wilde","year":"2007","journal-title":"Clin. Imaging"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2609","DOI":"10.3748\/wjg.v10.i17.2609","article-title":"EUS mini probes in diagnosis of cystic dystrophy of duodenal wall in heterotopic pancreas: A case report","volume":"10","author":"Jovanovic","year":"2004","journal-title":"World J. Gastroenterol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"313","DOI":"10.3748\/wjg.v13.i2.313","article-title":"An unusual cause of cholecystitis: Heterotopic pancreatic tissue in the gallbladder","volume":"13","author":"Elpek","year":"2007","journal-title":"World J. Gastroenterol."},{"key":"ref_7","first-page":"e2659","article-title":"A Rare Pathology Mimicking the Gallstone: Heterotopic Pancreas in the Gallbladder","volume":"10","author":"Ferhatoglu","year":"2018","journal-title":"Cureus"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1097\/MPA.0b013e31803816fc","article-title":"Heterotopic pancreas in the gallbladder: The importance of an uncommon condition","volume":"34","year":"2007","journal-title":"Pancreas."},{"key":"ref_9","first-page":"255","article-title":"Ectopias pancre\u00e1ticas [Pancreatic ectopias]","volume":"39","year":"1973","journal-title":"Rev. Esp. Enferm. Apar. Dig."},{"key":"ref_10","first-page":"57","article-title":"Adenocarcinoma arising in gastric heterotopic pancreas","volume":"135","author":"Hickman","year":"1981","journal-title":"West. J. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1016\/S0016-5085(12)90353-4","article-title":"Pathologic observations of intrahepatic peribiliary glands in 1000 consecutive autopsy livers: Heterotopic pancreas in the liver","volume":"98","author":"Terada","year":"1990","journal-title":"Gastroenterology"},{"key":"ref_12","first-page":"534","article-title":"Sui pancreas aberranti","volume":"4","author":"Poppi","year":"1935","journal-title":"Arch. Ital. Delle Mal. Appar. Dig."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s00104-006-1203-6","article-title":"Heterotopic pancreas in the gallbladder: Diagnosis, therapy, and course of a rare developmental anomaly of the pancreas","volume":"78","author":"Neupert","year":"2007","journal-title":"Chirurg"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"115","DOI":"10.4103\/ijabmr.IJABMR_109_18","article-title":"Pancreatic and Gastric Heterotopia in the Gallbladder: A Rare Incidental Finding","volume":"9","author":"Pendharkar","year":"2019","journal-title":"Int. J. Appl. Basic Med. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1007\/s003300050254","article-title":"Aberrant pancreas in the gallbladder wall","volume":"7","author":"Antoniou","year":"1997","journal-title":"Eur. Radiol"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"834","DOI":"10.15537\/smj.2018.8.22602","article-title":"Heterotopic pancreatic tissue in the gallbladder","volume":"39","author":"Sharma","year":"2018","journal-title":"Saudi Med. J."},{"key":"ref_17","first-page":"557","article-title":"Heterotopic pancreatic tissue in the gallbladder","volume":"152","author":"Sandbank","year":"1986","journal-title":"Acta Chir. Scand."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1007\/BF00730630","article-title":"An unusual cause of hydropic gallbladder and biliary colic--heterotopic pancreatic tissue in the cystic duct: Report of a case and review of the literature","volume":"23","author":"Inceoglu","year":"1993","journal-title":"Surg. Today"},{"key":"ref_19","first-page":"235","article-title":"Elevation of pancreatic enzymes in gallbladder bile associated with heterotopic pancreas. A case report and review of the literature","volume":"13","author":"Sato","year":"2012","journal-title":"JOP"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"14920","DOI":"10.1073\/pnas.2436557100","article-title":"Notch signaling controls multiple steps of pancreatic differentiation","volume":"100","author":"Murtaugh","year":"2003","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1038\/ng1273","article-title":"Conversion of biliary system to pancreatic tissue in Hes1-deficient mice","volume":"36","author":"Sumazaki","year":"2004","journal-title":"Nat. Genet."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.1172\/JCI27704","article-title":"Ectopic pancreas formation in Hes1 -knockout mice reveals plasticity of endodermal progenitors of the gut, bile duct, and pancreas","volume":"116","author":"Fukuda","year":"2006","journal-title":"J. Clin. Investig."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1272\/jnms.74.168","article-title":"A Case of Intra-abdominal Endocrine Tumor Possibly Arising from an Ectopic Pancreas","volume":"74","author":"Ogata","year":"2007","journal-title":"J. Nippon. Med. Sch."},{"key":"ref_24","first-page":"2021712","article-title":"Gastric Heterotopic Pancreas Presenting as Abdominal Pain with Acute and Chronic Pancreatitis in the Resected Specimen","volume":"2019","author":"Wawrzynski","year":"2019","journal-title":"Case Rep. Gastrointest. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"126","DOI":"10.4103\/0974-2727.180795","article-title":"Cholecystitis Associated with Heterotopic Pancreas, Pseudopyloric Metaplasia, and Adenomyomatous Hyperplasia: A Rare Combination","volume":"8","author":"Kaur","year":"2016","journal-title":"J. Lab. Physicians"},{"key":"ref_26","first-page":"701","article-title":"Ectopic pancreas in gallbladder. Clinical significance, diagnostic and therapeutic implications","volume":"107","year":"2015","journal-title":"Rev. Esp. Enferm. Dig."},{"key":"ref_27","first-page":"267","article-title":"Hemobilia by idiopathic aneurysm of cystic artery, fistulized in the biliary ways\u2014Clinical case","volume":"58","author":"Totolici","year":"2017","journal-title":"Rom. J. Morphol. Embryol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Dumitru, M., Berghi, O.N., Taciuc, I.-A., Vrinceanu, D., Manole, F., and Costache, A. (2022). Could Artificial Intelligence Prevent Intraoperative Anaphylaxis? Reference Review and Proof of Concept. Medicina, 58.","DOI":"10.3390\/medicina58111530"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/8\/1407\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:23:40Z","timestamp":1760127820000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/8\/1407"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,1]]},"references-count":28,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["medicina59081407"],"URL":"https:\/\/doi.org\/10.3390\/medicina59081407","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,1]]}}}