Incidental Jejunal Lesion Necessitating Intraoperative Change of Plan During Bariatric Surgery: a Video Case Report


Incidental gastric and small bowel lesions are commonly encountered during bariatric surgery. Resection of these lesions with negative margins in the same sitting is curative; however, this may necessitate intraoperative change of plan. We present a 44-year-old super obese lady in whom an exophytic jejunal mass was found at 80 cm from the ligament of Treitz, which necessitated a change of procedure from one anastomosis gastric bypass (OAGB) to Roux-en-Y gastric bypass (RYGB). The final pathology was ectopic pancreatic tissue. Running the small bowel during initial diagnostic laparoscopy should be a routine step before division of stomach, to avoid technical complexities when operative plan is changed in order to resect an incidentaloma. Bariatric surgeons should be well versed with all the standard bariatric procedures.

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  1. 1.

    Montalvo D, Hernandez P, Larrazabal A. Unexpected ectopic pancreatic tissue during laparoscopic bariatric surgery. Case report and literature review. Surg Obes Relat Dis. 2016;12(10):e87–8.

    Article  PubMed  Google Scholar 

  2. 2.

    BaMehriz F, Alali MN, Arishi H, et al. Incidental duodenal pancreatic heterotopia during laparoscopic sleeve gastrectomy: a case report and literature review. Am J Case Rep. 2019;20:1305–7.

    Article  PubMed  PubMed Central  Google Scholar 

  3. 3.

    Kung JW, Brown A, Kruskal JB, et al. Heterotopic pancreas: typical and atypical imaging findings. Clin Radiol. 2010;65(5):403–7.

    CAS  Article  PubMed  Google Scholar 

  4. 4.

    Subasinghe D, Sivaganesh S, Perera N, et al. Gastric fundal heterotopic pancreas mimicking a gastrointestinal stromal tumour (GIST): a case report and a brief review. BMC Res Notes. 2016;9(1):185.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  5. 5.

    Finnell CW, Madan AK, Ternovits CA, et al. Unexpected pathology during laparoscopic bariatric surgery. Surg Endosc Other Interv Tech. 2007;21(6):867–9.

    CAS  Article  Google Scholar 

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Correspondence to Sandeep Aggarwal.

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Kumar, A., Baksi, A., Yadavalli, S.D. et al. Incidental Jejunal Lesion Necessitating Intraoperative Change of Plan During Bariatric Surgery: a Video Case Report. OBES SURG (2021).

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  • Incidental jejunal lesion
  • Heterotopic pancreas
  • Ectopic pancreas
  • Bariatric surgery