Groove Pancreatitis: Report of a Case and Review of the Clinical and Radiologic Features of Groove Pancreatitis Reported in Japan.

Shudo, Ryushi; Yazaki, Yasuyuki; Sakurai, Shogo; Uenishi, Hiroshi; Yamada, Hiroto; Sugawara, Kenji; Okamura, Mitsu; Yamaguchi, Kiyotaka; Terayama, Hirotsugu; Yamamoto, Yasuhiro

doi:10.2169/internalmedicine.41.537

Cited by 45 publications

(40 citation statements)

References 14 publications

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“…Serum pancreatic (amylase, lipase, and elastase 1) and hepatic enzyme levels are sometimes slightly elevated [11,14]. Serum levels of carcinoembryonic antigen and carbohydrate antigen (CA 19-9) are usually normal [13].…”

Section: Diagnosismentioning

confidence: 99%

Groove Pancreatitis

et al. 2010

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Groove pancreatitis is a segmental chronic pancreatitis that affects the anatomical area between the pancreatic head, the duodenum, and the common bile duct, referred to as the groove area. Most patients with groove pancreatitis are males aged 40–50 years with a history of alcohol abuse. In about 20% of patients undergoing pancreaticoduodenectomy to treat chronic pancreatitis, groove pancreatitis is detected. The clinical symptoms are weight loss, upper abdominal pain, postprandial vomiting, and nausea due to duodenal stenosis. The pathogenesis of groove pancreatitis is thought to be anatomical or functional obstruction of the minor papilla. The viscosity of pancreatic juice increases due to excessive alcohol consumption and/or smoking, leading to calcification of the pancreatic duct. According to these conditions, pancreatitis in the groove area might arise due to impaired pancreatic juice outflow. The descending part of the duodenum is usually stenotic. Severe fibrosis and scarring are evident in the groove area. Characteristic pathological findings are cystic lesions in the duodenal wall, Brunner gland hyperplasia, dilation of Santorini’s duct and protein plaques in the pancreatic duct. A differential diagnosis of groove pancreatitis from peripancreatic cancer is clinically important. Cystic lesions in the duodenal wall and smooth stenosis of the bile duct are important findings of groove pancreatitis revealed by endoscopic ultrasonography, computed tomography and magnetic resonance imaging. Biopsy through the duodenum is also useful for diagnosis. Conservative treatment options include endoscopic stenting of the minor papilla, but long-term outcomes remain unclear. Pancreatoduodenectomy is a rational treatment for symptomatic groove pancreatitis.

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Section: Diagnosismentioning

confidence: 99%

Groove Pancreatitis

et al. 2010

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“…Conservative treatment has been suggested in the acute phase of GP including bed rest, fasting, analgesia and parenteral nutrition [33]. Effectiveness of this treatment should be evaluated after 4-6 weeks in terms of clinical symptoms, laboratory data and imaging findings (Fig.…”

Section: Treatment Of Gpmentioning

confidence: 99%

Groove pancreatitis: a diagnostic challenge

et al. 2009

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Groove pancreatitis is a distinct form of chronic pancreatitis characterized by inflammation and fibrous tissue formation, affecting the groove area between the head of the pancreas, the duodenum and the common bile duct. It is manifested on imaging by a sheet-like mass in the groove area near the minor papilla. Thickening of the duodenal wall and cystic transformation in the duodenal wall also represent common imaging features. Pathogenesis is still unclear, and clinical presentation is not specific. Endoscopic ultrasonography (EUS), computed tomography (CT) and magnetic resonance imaging (MRI) demonstrate imaging findings consistent with the disease in typical cases, but specific diagnosis is challenging in a number of patients where biopsy is required. The disease may mimic pancreatic, common bile duct or duodenal wall cancer that requires prompt and excessive surgical intervention, as opposed to groove pancreatitis where initial conservative treatment is suggested. The clinical, histopathological and radiological features on cross-sectional imaging of this entity are discussed in this review, and differential diagnostic clues are given.

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“…Se han descrito varios factores, como úlceras pépticas (fundamentalmente en la forma segmentaria 10 ), resección gástrica, quistes verdaderos en la pared duodenal, y heterotopia pancreática en el duodeno 5 . Shudo et al 3,7 indican que un conducto de Santorini anómalo podría ser uno de los factores más importantes involucrados en su etiopatogenia, principalmente en la forma segmentaria de la enfermedad. Así, explican que cuando la salida del jugo pancreático en el conducto de Santorini está interrumpido por alguna razón, como, por ejemplo, una hiperplasia de las glándulas de Brunner, éste se dirige retrógradamente hacia el cuerpo pancreático, encontrándose en su trayecto un obstáculo en el ángulo agudo formado por la llamada )rodilla wirsungniana*, estancándose en esta localización y condicionado, entonces, una interferencia y un temporal retroceso en la secreción pancreática de las zonas periféricas de la cabeza pancreática, lo que explicaría la pancreatitis del surco tipo segmentaria.…”

Section: Article In Pressunclassified

“…Esta entidad es una forma segmentaria de pancreatitis crónica que causa una cicatriz laminar en el área del surco 1,2 . Fue descrita por primera vez en 1973 por Becker y Bauchspeichel 3,4 .…”

Section: Introductionunclassified