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Pancreatic heterotopia is defined as the presence of pancreatic tissue outside of its normal anatomical location. It has an independent blood supply and lacks a physical connection to the pancreas. It is also known as ectopic pancreas or pancreatic rest.

Heterotopic pancreatic tissue is found in up to 15% of individuals at autopsy. However, since majority of the cases are asymptomatic, the incidence in surgical specimens is about 0.2%.

The major locations are stomach, duodenum, jejunum, ileum, and Meckel's diverticulum. Stomach alone accounts for about 30% of cases. The duodenal cases involve the second portion several centimeters proximal to the ampulla of Vater. Rare locations include gall bladder, bile ducts, umbilicus, mesentery, esophagus, lungs, and mediastinum.

This wedge resection specimen shows a dome-shaped, intramural nodule within gastric wall, with smooth overlying mucosa.

Image courtesy of Dr. Jean-Christophe Fournet, Paris, France; humpath.com; Used with permission
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