Groove pancreatitis: A Case Report and Review of the Literature

Abstract

Groove pancreatitis is a rare form of segmental chronic pancreatitis. It involves the anatomic space between the head of the pancreas, the duodenum and the common bile duct. It was first described in the early 1970s, but it remains largely unfamiliar to most physicians. Radiological diagnosis can be challenging, as it is often difficult to differentiate it from other entities. The differential diagnosis from pancreatic head carcinoma may be difficult and recognition of subtle differences between these two entities is extremely important as the management differs significantly. Groove pancreatitis can be managed by conservative medical treatment, and surgery is reserved only for patients with persistent and severe clinical symptoms. We present a case of a 27 year-old male with groove pancreatitis and discuss the Magnetic Resonance Imaging (MRI) appearance of this entity as well as the differential diagnosis.

Paraduodenal pancreatitis as an uncommon cause of gastric outlet obstruction: A case report and review of the literature

“…PP is a form of chronic or recurrent focal pancreatitis [1] , [2] , [4] , [5] , [6] , [7] , [8] , [9] . It affects the gastroduodenal groove, which is an area between the dorso-cranial portion of the pancreatic head, duodenum, and CBD [1] , [2] , [4] , [5] . It was first described in the French literature in 1970, and subsequently the English literature in 1993, as “cystic dystrophy of the duodenal wall developing in heterotopic pancreas” by Potet et al [10] , [11] .…”

“…In published surgical series of patients undergoing pancreaticoduodenectomy for the indication of chronic pancreatitis, the incidence varied from 2.7% to 24.5% [4] . PP generally presents with symptoms of abdominal pain, nausea, postprandial vomiting, and long-term weight loss [1] , [2] , [4] , [5] , [6] , [7] . Duodenal luminal obstruction leading to gastric outlet obstruction is rare [7] .…”

“…Duodenal luminal obstruction leading to gastric outlet obstruction is rare [7] . Cancer antigen 19-9 and carcinoembryonic antigen tumor markers are usually normal, while amylase and lipase may be elevated during an acute flair of pain [4] , [7] , [9] . The time to diagnosis is highly variable and depends on the treating phycian’s familiarity with the diagnosis.…”

“…PP is most commonly seen in Caucasian men in their fifth decade of life, and particularly in those with a history of alcohol abuse [1] , [2] , [4] , [5] , [6] , [7] , [9] , [13] . To date, the largest reported series examined 105 patients; 91% were male while 86% were described as chronic alcoholics [13] .…”

Groove Pancreatitis Masquerading as Carcinoma Pancreas : A Diagnostic Dilemma

“…Groove pancreatitis has been addressed with multiple names like cystic dystrophy of heterotopic pancreas, myoadenomatosis, paraduodenal wall cyst, paraduodenal pancreatitis. The exact incidence is not known, it varies from 2.7 to 24.5% cases of whipples1,3 procedure done for chronic pancreatitis . It can be of two types, Pure 3 and Segmental form as described by Becker et al in 1991.…”