Ectopic Pancreas: A Chameleon of Abdominal Symptoms

Ectopic pancreas, also known as heterotopic pancreas, is a congenital anomaly characterised by pancreatic tissue located outside its normal anatomical location, without structural, vascular, or ductal continuity with the native pancreas. Although often asymptomatic, an ectopic pancreas may present as an abdominal mass and radiologically mimic other pathologies, resulting in diagnostic uncertainty and frequently leading to surgical intervention. We report two cases: a 49-year-old man who presented with abdominal discomfort and fullness and was found to have a 2 cm lesion at the duodenojejunal flexure. Workup failed to delineate the nature of the lesion, and the patient underwent resection, revealing ectopic pancreas. A 33-year-old female presented with symptoms of small bowel obstruction. Extensive workup, including capsule endoscopy, revealed an intraluminal polypoid lesion, and underwent laparotomy and resection. In both cases, histopathology confirmed ectopic pancreas. These cases highlight the diagnostic challenges that ectopic pancreas may pose and emphasise its role as a true "chameleon" of abdominal pathology. Its variable clinical and radiological presentations underscore the importance of considering ectopic pancreas in the differential diagnosis of symptomatic gastrointestinal masses.