{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:48:48Z","timestamp":1787071728435,"version":"build-2736575974"},"reference-count":6,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Heterotopic pancreas (HP) is a rare congenital anomaly, characterised by ectopic pancreatic tissue lacking anatomical and vascular continuity with the main pancreas. Its clinical and radiological presentation often mimics gastrointestinal stromal tumours (GIST), making pre-operative diagnosis challenging. They are usually asymptomatic but can rarely present with symptoms like GI bleed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective study analysed the four cases of HP in the gastroduodenal region, diagnosed over the past 4 years. All patients underwent minimally invasive surgical excision based on pre-operative suspicion of GIST. Clinical presentation, imaging findings, surgical approach and histopathological results were reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The study included four male patients aged 18\u201362 years. The symptoms ranged from post-prandial abdominal pain and discomfort to asymptomatic incidental findings and haemoptysis. Contrast-enhanced computed tomography (CECT) revealed nodular lesions (1.6\u20132.7 cm) with exophytic or endophytic growth patterns, raising the suspicion for GIST. Robotic-assisted excision was performed in three cases and laparoscopic excision in one. Histopathological examination confirmed HP in all cases, classified as Heinrich type 1 or 2, with one case showing an additional adenomyoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>HP should be considered in submucosal or intramural GI lesions, especially when mimicking GISTs or showing umbilication on endoscopy. Surgical resection is recommended for the symptomatic cases or diagnostic uncertainty, with minimally invasive approaches preferred. Our series highlights the first robotic excision of duodenal HP in the literature.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jmas.jmas_42_25","type":"journal-article","created":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T06:00:25Z","timestamp":1765000825000},"page":"92-96","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic dilemma in gastroduodenal lesions: Heterotopic pancreas mimicking gastrointestinal stromal tumours managed by minimally invasive approach \u2013 A case series and review of the literature"],"prefix":"10.4103","volume":"22","author":[{"given":"D.","family":"Raghavendra","sequence":"first","affiliation":[{"name":"Department of Surgical Gastroenterology, Apollo Hospitals, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Gilbert Samuel","family":"Jebakumar","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology, Apollo Hospitals, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeevanandham","family":"Muthiah","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology, Apollo Hospitals, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav","family":"Chinappa","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology, Apollo Hospitals, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddhesh Suresh","family":"Tasgaonkar","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology, Apollo Hospitals, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkatesh","family":"Munikrishnan","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology, Apollo Hospitals, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudeepta Kumar","family":"Swain","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology, Apollo Hospitals, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12,5]]},"reference":[{"key":"R1-20260121","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1148\/rg.2017160091","article-title":"Heterotopic pancreas:Histopathologic features, imaging findings, and complications","volume":"37","author":"Rezvani","year":"2017","journal-title":"Radiographics"},{"key":"R2-20260121","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1186\/s13244-021-01089-0","article-title":"Insight into gastrointestinal heterotopic pancreas:Imaging evaluation and differential diagnosis","volume":"12","author":"Yang","year":"2021","journal-title":"Insights Imaging"},{"key":"R3-20260121","doi-asserted-by":"crossref","first-page":"45","DOI":"10.14740\/gr1363","article-title":"Gastrointestinal tract heterotopic pancreas:Asymptomatic pathology?","volume":"14","author":"Farah","year":"2021","journal-title":"Gastroenterology Res"},{"key":"R4-20260121","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.3748\/wjg.v28.i14.1455","article-title":"Clinical classification of symptomatic heterotopic pancreas of the stomach and duodenum:A case series and systematic literature review","volume":"28","author":"LeCompte","year":"2022","journal-title":"World J Gastroenterol"},{"key":"R5-20260121","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/s12893-017-0250-x","article-title":"Clinical impact of duodenal pancreatic heterotopia \u2013Is there a need for surgical treatment?","volume":"17","author":"Betzler","year":"2017","journal-title":"BMC Surg"},{"key":"R6-20260121","doi-asserted-by":"crossref","first-page":"179","DOI":"10.4103\/jmas.JMAS_1_19","article-title":"Ectopic pancreas mimicking gastric submucosal tumour treated using robotic surgery","volume":"16","author":"Chang","year":"2020","journal-title":"J Minim Access Surg"}],"container-title":["Journal of Minimal Access Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_42_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:52:36Z","timestamp":1787068356000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_42_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,5]]},"references-count":6,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jmas.jmas_42_25","relation":{},"ISSN":["0972-9941","1998-3921"],"issn-type":[{"value":"0972-9941","type":"print"},{"value":"1998-3921","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,5]]},"assertion":[{"value":"2025-01-26","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-27","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}