Dual-Focused Type I Heterotopic Pancreas in the Gastric Antrum: A Rare Case with Clinical-Anatomical Implications

Heterotopic pancreas (HP) is a rare congenital anomaly defined by pancreatic tissue outside the normal anatomical pancreas without ductal or vascular continuity. Although frequently asymptomatic, lesions located in the gastric antrum may produce dyspeptic symptoms and delayed gastric emptying because of their proximity to the pylorus. This study reports a case of a 40-year-old male with an exceptionally rare dual-focal Type I HP confined to the gastric antrum who recovered uneventfully following laparoscopic wedge resection. Endoscopic ultrasonography demonstrated a submucosal protrusion, and contrast-enhanced computed tomography revealed a 4-cm mass. Laparoscopic wedge resection was performed; however, intraoperative exploration revealed a second synchronous 2-cm lesion that was also excised. Histopathological evaluation confirmed Heinrich Type I HP with acini, ducts, and islets. Postoperatively, the patient recovered uneventfully and was discharged on day three. This case highlights the diagnostic challenge of antral lesions and emphasises the clinical relevance of anatomical localization, as even small lesions may cause symptoms when two foci coexist. Dual-focal antral involvement is exceptionally rare and contributes novel evidence to the literature.