Gastric outlet obstruction caused by heterotopic pancreas

Heterotopic pancreas (HP) in the stomach is a relatively well-known entity, but there are not many symptomatic cases reported in children. We report on a 9-year-old boy presenting with nausea and vomiting. The first gastroscopic examination showed a crater-like lesion in the antrum, but at follow-up gastroscopy a few weeks later the lesion was polypoid, obstructing the pylorus. Endoscopic biopsy was not diagnostic, but histological examination after open excision showed HP. It is unclear why the lesion changed so markedly in appearance in just a few weeks. HP is a rare cause of gastric outlet obstruction in children.