Complete duodenal obstruction induced by groove pancreatitis: A case report

Abstract

BACKGROUNDGroove pancreatitis (GP) is a type of chronic pancreatitis occurring in an anatomic area between the duodenum, head of the pancreas, and common bile duct. Duodenal obstruction is always caused by malignant pancreatic diseases, such as pancreatic head carcinoma, while is rarely induced by benign pancreatic diseases, such as pancreatitis.CASE SUMMARYA 39-year-old man presented with a 1-mo history of upper abdominal discomfort. His concomitant symptoms were abdominal distension, postprandial nausea, and vomiting. Contrast-enhanced computed tomography of the abdomen showed thickening of the intestinal wall with enhancement of the descending segment of the duodenum, which could not be clearly differentiated from the head of the pancreas. Upper gastrointestinal radiographs and gastrointestinal endoscopy showed a complete obstruction of the descending duodenum. An operation found that a 3-cm mass was located in the “groove part” of the pancreas and oppressing the descending duodenum. Pancreaticoduodenectomy was performed to relieve the obstruction and thoroughly remove the pancreatic lesions. The pathologic diagnosis was pancreatitis. The patient had an uneventful recovery with no complications.CONCLUSIONBecause of the special location and the contracture induced by long-term chronic inflammation, our case reminds surgeons that some benign pancreatic diseases, such as GP, can also present with symptoms similar to those of pancreatic cancer. This knowledge can help to avoid an unnecessary radical operation.

Lemmel syndrome: an unusual cause of biliary obstruction secondary to a duodenal juxta-ampullary diverticulum: a report of two cases

“…Para duodenal pancreatitis, also known as groove pancreatitis, is a type of chronic pancreatitis occurring in a particular anatomical area between the duodenum, the head of the pancreas, and the common bile duct. It is characterized by cystic thickening of the duodenal wall and fibrous pancreatic duodenal furrow in the form of a curvilinear crescent [11 , 12] .…”

Duodenal Obstruction in a Patient Previously Treated With EndoVascular Aneurysm Sealing System Repair

“…9,10 Other causes include groove pancreatitis, aortoduodenal syndrome, post-surgical adhesions, tuberculosis, primary intestinal lymphoma, Crohn's disease, eosinophilic gastroenteritis, gastrointestinal stromal tumor and Wilkie's syndrome. [11][12][13][14] Distal DO is a clinical and radiological entity characterized by features of gastric outlet obstruction, with recurrent bilious vomiting and radiological evidence of post-bulbar obstruction. 15 Common clinical features of distal DO include epigastric/periumbilical pain, nausea, vomiting, early satiety, weight loss and rarely, abdominal distention.…”

Causes of upper gastrointestinal tract obstruction

“…Due to the similarity of clinical and radiological symptoms to those of carcinoma of the pancreatic head, the diagnosis of groove pancreatitis remains a significant clinical challenge. Exceptionally, groove pancreatitis can cause duodenal stenosis and obstruction (40) . Treatment includes prevention, surgical or endoscopic procedures.…”