Umbilical heterotopic pancreas in an infant: a case report

Introduction

Heterotopic pancreas is a rare congenital anomaly in which pancreatic tissue is located outside its normal anatomical position without any ductal or vascular connection to the main pancreas. Umbilical heterotopic pancreas is extremely uncommon.

Case presentation

A 5-month-old male was brought to our clinic due to persistent clear umbilical discharge since birth. He was born at term following an uneventful pregnancy and delivery, with no antenatal or perinatal complications. Physical examination revealed a mildly erythematous umbilicus with serous discharge but no signs of infection or systemic illness. The initial diagnosis was umbilical granuloma. Due to persistent symptoms, we took the patient to the operating room for a surgical excision. Intraoperatively, a small firm nodule was identified beneath the umbilical skin. The lesion was well-circumscribed but inseparable from the overlying umbilical tissue. There was no communication with intra-abdominal viscera. Complete excision of the umbilicus and the subcutaneous lesion was performed, followed by umbilicoplasty. Histopathological analysis revealed ectopic pancreatic tissue composed of acini, ducts, and islets of Langerhans, confirming the diagnosis of umbilical heterotopic pancreas. The patient recovered uneventfully and was discharged home on the second postoperative day. At four-weeks of follow-up, the surgical site was well healed, with no recurrence or discharge.

Conclusion

Although rare, umbilical heterotopic pancreas should be included in the differential diagnosis of infants who present umbilical discharge.