Evaluation of unusual causes of pancreatitis: Role of cross-sectional imaging

Kwak, Sang Wook; Kim, Suk; Lee, Jun Woo; Lee, Nam Kyung; Kim, Chang Won; Yi, Mi Seon; Kim, Gwang Ha; Kang, Dae Hwan

doi:10.1016/j.ejrad.2008.04.006

Cited by 24 publications

(12 citation statements)

References 47 publications

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“…1, 3, 4, and 6). Notably, this soft tissue often has a “sheetlike” curvilinear crescentic shape that is best appreciated on coronal multiplanar reformatted images [11] (Figs. 2 and 7).…”

Section: Imaging Findingsmentioning

confidence: 99%

“…3). It is rare to visualize fluid in the pararenal spaces or surrounding the pancreas, and diffuse inflammatory change is usually minimal [11–14]. Notably, in both forms, the common bile duct can appear attenuated and narrowed, a feature often best appreciated on the coronal multiplanar reformats.…”

Section: Imaging Findingsmentioning

confidence: 99%

“…The pancreatic duct can also be narrowed toward the downstream pancreatic head, typically in a smooth gradual fashion. In a more chronic setting, changes in the pancreatic parenchyma resembling those of traditional chronic pancreatitis can develop secondary to this progressive narrowing and fibrosis of the downstream pancreatic duct, including pancreatic calcifications, ductal dilatation, and ductal beading or irregularity [11–14] (Fig. 4).…”

Section: Imaging Findingsmentioning

confidence: 99%

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Groove Pancreatitis: Spectrum of Imaging Findings and Radiology-Pathology Correlation

Raman

Salaria

Hruban

et al. 2013

American Journal of Roentgenology

115

109

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OBJECTIVE Groove pancreatitis is a rare form of chronic pancreatitis affecting the “groove” between the pancreatic head, duodenum, and common bile duct. The exact cause is unknown, although there are strong associations with long-term alcohol abuse, functional obstruction of the duct of Santorini, and Brunner gland hyperplasia. CONCLUSION Unfortunately, differentiating groove pancreatitis from malignancy on the basis of imaging features, clinical presentation, or laboratory markers can be extraordinarily difficult, and the vast majority of these patients ultimately undergo a pancreaticoduodenectomy (Whipple procedure) because of an inability to completely exclude malignancy. In certain cases, however, the imaging features on CT and MRI can allow the radiologist to prospectively suggest the correct diagnosis.

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Section: Imaging Findingsmentioning

confidence: 99%

Section: Imaging Findingsmentioning

confidence: 99%

Section: Imaging Findingsmentioning

confidence: 99%

See 1 more Smart Citation

Groove Pancreatitis: Spectrum of Imaging Findings and Radiology-Pathology Correlation

Raman

Salaria

Hruban

et al. 2013

American Journal of Roentgenology

115

109

View full text Add to dashboard Cite

show abstract

“…Alcoholism and choledocholithiasis are the most common etiological factors for this disease [2][3][4][5][6] . The clinical variety of mild acute pancreatitis (70%-80% of patients), also called edematous interstitial pancreatitis, exhibits a self-limiting disease with no or minimal organ dysfunction, without complications, and with a favorable prognosis [1] .…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging for acute pancreatitis

Xiao¹

2010

WJR

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Acute pancreatitis is characterized by acute chemical injury of the pancreatic parenchyma and peripancreatic tissue. The increased frequency of death in acute pancreatitis is directly correlated with the degree and progress of pancreatic necrosis. Moreover, the occurrence of some local complications in acute pancreatitis, such as pancreatic hemorrhage, peripancreatic abscess or large pseudocyst, and pseudoaneurysm, could influence the choice of treatment for these patients. Magnetic resonance imaging (MRI) can be used to help evaluate the presence and degree of pancreatic necrosis, and is crucial for identifying complications of acute pancreatitis and predicting prognosis. The purpose of this article is to describe MRI techniques for acute pancreatitis, to review the spectrum of pancreatic and peripancreatic patterns, as well as to survey various complications secondary to acute pancreatitis on MRI. The role of MRI in the initial evaluation and staging of acute pancreatitis is emphasized.

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“…This area appeared hypodense on both phases and the appearance ranged from a mass like area to peripancreatic stranding around the head. This abnormality, previously been described as an area of “sheet-like” curvilinear and crescentic morphology [16] representing chronic inflammatory and fibrotic changes, was seen in all patients. The hypoenhancement on the arterial and venous phases on dual phase MDCT is similar to pancreatic cancer [9,17] when it arises in the PD groove, or similar to the focal pancreatitis that is sometimes seen in association with a mass obstructing the pancreatic duct.…”

Section: Discussionmentioning

confidence: 59%

Dual-phase CT findings of groove pancreatitis

Zaheer

Haider

Kawamoto

et al. 2014

European Journal of Radiology

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Purpose Groove pancreatitis is a rare focal form of chronic pancreatitis that occurs in the pancreaticoduodenal groove between the major and minor papillae, duodenum and pancreatic head. Radiologic appearance and clinical presentation can result in suspicion of malignancy rendering pancreaticoduodenectomy inevitable. This study reports dual phase CT findings in a series of 12 patients with pathology proven groove pancreatitis. Materials and methods Retrospective review of preoperative CT findings in 12 patients with histologically proven groove pancreatitis after pancreaticoduodenectomy. Size, location, attenuation, presence of mass or cystic components in the pancreas, groove and duodenum, calcifications, duodenal stenosis and ductal changes were recorded. Clinical data, laboratory values, endoscopic ultrasonographic and histopathological findings were collected. Results Soft tissue thickening in the groove was seen in all patients. Pancreatic head, groove and duodenum were all involved in 75% patients. A discrete lesion in the pancreatic head was seen in half of the patients, most of which appeared hypodense on both arterial and venous phases. Cystic changes in pancreatic head were seen in 75% patients. Duodenal involvement was seen in 92% patients including wall thickening and cyst formation. The main pancreatic duct was dilated in 7 patients, with an abrupt cut off in 3 and a smooth tapering stricture in 4. Five patients had evidence of chronic pancreatitis with parenchymal calcifications. Conclusion Presence of mass or soft tissue thickening in the groove with cystic duodenal thickening is highly suggestive of groove pancreatitis. Recognizing common radiological features may help in diagnosis and reduce suspicion of malignancy.

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Evaluation of unusual causes of pancreatitis: Role of cross-sectional imaging

Cited by 24 publications

References 47 publications

Groove Pancreatitis: Spectrum of Imaging Findings and Radiology-Pathology Correlation

Groove Pancreatitis: Spectrum of Imaging Findings and Radiology-Pathology Correlation

Magnetic resonance imaging for acute pancreatitis

Dual-phase CT findings of groove pancreatitis

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