Wandering pancreas

　　The occurrence of wandering pancreas is related to embryonic developmental abnormalities. At the 6th to 7th week of human embryo development, during the rotation and fusion process of the dorsal and ventral pancreatic primordia with the superior part of the primitive gut, if one or more pancreatic primordia cells remain in the wall of the primitive gut, due to the longitudinal growth of the primitive gut, the pancreatic primordia can be carried away. The cell tissue produced by the dorsal pancreatic primordia will be carried to the stomach; the one produced by the ventral pancreatic primordia will be carried to the jejunum, becoming an ectopic pancreas. If the pancreatic primordia extend into the gastrointestinal wall, biliary system, omentum, even the spleen, pancreatic tissue will appear in these organs, which is also called wandering pancreas.

　　Wandering pancreas can be found in any part of the abdominal cavity, with the duodenum being the most common, accounting for about 27.7%; the stomach is the next most common, accounting for about 25.5%; the jejunum accounts for about 15%; the ileum and Meckel's diverticulum account for about 3%; occasionally, it can also be found in the gallbladder, bile duct, liver, spleen, mesentery, omentum, cecum, appendix, umbilical orifice, and so on. The common complications of this disease include acute pancreatitis, chronic pancreatitis, cysts, adenomas, adenocarcinomas, and so on.

　　Vaginal pancreas usually has no symptoms and can be discovered accidentally during surgery or examination. Due to its growth in certain special locations or other pathological changes, it can present with the following six clinical manifestations, which are also known as six types by some people:

　　1. Obstructive type

　　An ectopic pancreas growing in the digestive tract can cause compression or narrowing of the organ it is located in, leading to obstructive symptoms. For example, it can cause pyloric stenosis if located in the antrum of the stomach; it can cause biliary obstruction if located in the Vater's ampulla; it can cause intestinal obstruction or intussusception if located in the intestines, and so on.

　　2. Hemorrhagic type

　　Ectopic pancreas is prone to cause gastrointestinal bleeding, the cause of which may be the congestion and erosion of the surrounding gastrointestinal mucosa of the ectopic pancreas, or the invasion of the mucosal blood vessels of the gastrointestinal tract leading to gastrointestinal bleeding.

　　3. Ulcer type

　　Ectopic pancreas located in the gastrointestinal tract can secrete trypsin due to stimulation by digestive juices, digesting the gastric and intestinal mucosa to form ulcers; ectopic pancreas located beneath the mucosa can compress the upper mucosa, causing atrophy of the mucosa, and then ulcers may occur.

　　4. Tumor type

　　If the ectopic pancreas is located in the submucosal layer of the gastrointestinal tract, it can cause local bulging of the mucosa; if located in the muscular layer, it can cause the stomach wall or intestinal wall to thicken, and it is easily misdiagnosed as a gastrointestinal tumor. Occasionally, ectopic pancreatic tissue may develop insulinoma, causing hypoglycemia; malignant changes will then appear with the symptoms of pancreatic cancer.

　　5. Diverticulum type

　　Ectopic pancreatic tissue can be located in congenital diverticula of the gastrointestinal tract, especially in Meckel's diverticula, which is the most common, and may also appear with symptoms such as diverticulitis and hemorrhage.

　　6. Hidden type

　　Due to the congenital developmental abnormality of ectopic pancreas, some cases may have no symptoms throughout their lives, or be discovered accidentally during surgery or examination.

　　Vagus pancreas, also known as ectopic pancreas or accessory pancreas, refers to isolated pancreatic tissue that grows outside the pancreas itself, has no anatomical connection with the normal pancreatic tissue, and has no vascular connection. It is called ectopic pancreas. It belongs to a congenital malformation. Currently, there is no effective preventive method.

　　When diagnosing vagus pancreas, in addition to relying on its clinical manifestations, auxiliary examinations are also needed. Currently, there is a lack of specific examination methods. Upper gastrointestinal barium meal examination, cholecystography, endoscopy, and biopsy can be performed.

　　Vagus pancreas, also known as ectopic pancreas, can be found in any part of the abdominal cavity. No treatment is necessary when asymptomatic, but surgical treatment is required after symptoms appear. In terms of diet, the following foods can be eaten more:

　　1, Soybeans:It is advisable to consume 200-300 grams per day. Soybeans are alkaline foods that can neutralize the effect of gastric acid, reduce the stimulation of gastric acid on the gastric mucosa, reduce reflux, and are beneficial to the patient's recovery.

　　2, Milk:It is advisable to consume 300-400 milliliters per day. Milk is rich in high-quality protein nutrients and has the effect of protecting the gastric mucosa, promoting the absorption of nutrients, enhancing the body's immunity, and benefiting the patient's recovery.

　　3, Winter melon:It is advisable to consume 200-300 grams per day. Winter melon belongs to fiber-rich foods and contains crude fibers that stimulate gastrointestinal motility, promote the excretion of harmful substances in the intestines, and are beneficial to the patient's recovery.

　　Vagus pancreas, also known as ectopic pancreas, should be treated surgically when the disease causes significant symptoms due to pathological changes. Procedures such as subtotal gastrectomy, intestinal resection, and diverticulectomy may be performed. For smaller lesions, partial resection of the gastric or intestinal wall may be performed, followed by suture of the gastric wall or intestines. It is forbidden to try to simply剥离 the ectopic pancreas tissue from the gastric or intestinal wall. If ectopic pancreas is accidentally found during other surgeries and the patient has no symptoms caused by ectopic pancreas before surgery, it should be resected simultaneously as much as possible if it does not affect the original surgery and the resection of the ectopic pancreas is not difficult. Frozen sections should also be performed during surgery, and if there is malignancy, the resection range should be expanded or radical surgery should be performed.