Surgical management of groove pancreatitis: a case report

Ismail, Imen Ben; Zenaidi, Hakim; Yahmadi, Abdelwahed; Rebii, Saber; Zoghlami, Ayoub

doi:10.11604/pamj.2020.36.99.21873

Cited by 4 publications

(5 citation statements)

References 16 publications

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“…Surgical treatment options may include pancreaticoduodenectomy and gastrojejunostomy, as well as choledochotomy with T-tube drainage (11,28,29). Pancreaticoduodenectomy has been shown to markedly reduce the use of painkillers and completely eliminate clinical symptoms in patients with late-stage complications such as obstruction and severe pain, but there is a lack of relevant outcome studies available to confirm its efficacy (6,12,30,31).…”

Section: Discussionmentioning

confidence: 99%

Groove pancreatitis presenting with upper gastrointestinal obstruction and abnormal renal function: A case report and literature review

Fan,

Shi,

2024

Exp Ther Med

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Groove pancreatitis (GP) is a rare type of chronic pancreatitis characterized by fibrotic lesions localized to the groove between the pancreatic head, duodenum, and common bile duct. We present a case of a 59-year-old male alcoholic with vomiting and renal dysfunction found to have duodenal obstruction and low-density pancreatic head lesions on computed tomography concerning for GP. The patient underwent pancreaticoduodenectomy and pathology confirmed the diagnosis postoperatively. The patient recovered well without complications or relapse at follow-up. Although rare, GP should be included in the differential for pancreatic head masses in middle-aged alcoholics and surgical resection may be necessary for symptom relief and exclusion of malignancy.

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Section: Discussionmentioning

confidence: 99%

Groove pancreatitis presenting with upper gastrointestinal obstruction and abnormal renal function: A case report and literature review

Fan,

Shi,

2024

Exp Ther Med

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“…In this way, the pressure within the Santorini duct increases, ultimately forming pseudocysts [8]. Brunner gland hyperplasia, ectopic pancreatic tissue, true duodenal wall cysts, history of gastrectomy, gastroduodenal ulcer, biliary diseases, and the presence of anatomic abnormalities are also associated with the disease [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…In case patients are not clinically improved, present with complications, or the possibility of malignancy cannot be ruled out, the most suitable approach is surgery. Pancreatoduodenectomy, with Whipple's procedure or with preservation of pylorus-Longmire technique, is the most commonly used method because it provides both a definitive cure of the symptoms and resection of possible malignancy [4,7,10]. Casetti et al observed a percentage of 76% pain remission in patients after pancreatoduodenectomy [7].…”

Section: Discussionmentioning

confidence: 99%

“…In the event of pyloric or duodenal stenosis, a condition present in our case, procedures such as duodenal or biliary bypass constitute a therapeutic option. Otherwise, in the absence of duodenal stenosis, an alternative surgical approach is groove resection of the pancreatic head (GRPH), which includes the resection of the groove area of the pancreatic head with preservation of the duodenum, common bile duct, main pancreatic duct, and the majority of the pancreatic head [10].…”

Section: Discussionmentioning

confidence: 99%

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Surgical Management of Groove Pancreatitis: A Case Report

Ioannidis

Menni

Tzikos

et al. 2023

JPM

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Groove pancreatitis (GP) is a chronic type of pancreatitis involving the groove area between the head of the pancreas, the duodenum, and the common bile duct. Alcohol abuse is one of the main pathogenetic factors, although its etiology is not clearly defined. Differential diagnosis of pancreatic disorders remains difficult. The lack of diagnostic management and the restrictive number of patients are the main barriers. This article presents a case of a 37-year-old male diagnosed with GP after several episodes of epigastric pain and vomiting, with a history of chronic alcohol consumption. The patient’s radiological and laboratory results excluded the possibility of malignancy and suggested the diagnosis of groove pancreatitis with duodenal stenosis. After initial conservative treatment failed, surgical management was decided. A gastroenteroanastomosis was made in order to bypass the duodenum aiming for a total resolution of the symptoms and an uneventful recovery of the patient. Although most studies suggest pancreatoduodenectomy (Whipple’s procedure) as the treatment of choice, a less major procedure can be performed in evidence of malignancy absence.

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“…This leads to a hyperplasia of the Brunner's glands, which is the most common finding in histological analysis [5] and causes occlusion or dysfunction of the minor papilla [6][7][8]. Other causes of minor papilla dysfunction that are related to this entity are a history of gastrectomy, gastroduodenal ulcer, and biliary diseases and the presence of anatomic abnormalities such as ectopic pancreatic tissue in the duodenum or pancreatic divisum [10,11]. The initial clinical presentation is nonspecific, and the most common manifestations are upper abdominal pain, nausea, vomiting, and weight loss, primarily due to duodenal obstruction [5,8,12].…”

Section: Discussionmentioning

confidence: 99%

Upper Gastrointestinal Bleeding as a Debut Form of Groove Pancreatitis: A Diagnostic Challenge

Matías‐García

Castellón-Pavón

Díaz-García

et al. 2022

Case Reports in Surgery

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Introduction. Groove pancreatitis (GP) is an unusual subtype of chronic pancreatitis that affects the groove area. Differential diagnosis between groove pancreatitis and pancreatic carcinoma (PC) can be challenging, both clinically and radiologically. Our aim is to report the first case of GP debut with upper gastrointestinal bleeding (UGB). Case Report. A 53-year-old man with a personal history of alcohol and tobacco abuse and chronic pancreatitis was admitted to the hospital for epigastric abdominal pain. A computed tomography scan showed a locally advanced neoformative lesion in the distal stomach. The patient presented melena, arterial hypotension, and 4.4 g/dl of hemoglobin. An upper gastrointestinal endoscopy showed a neoformative ulcerated lesion at the duodenal bulb without active bleeding. Biopsies were taken, and histopathological analysis did not show malignancy. A cephalic pancreaticoduodenectomy was performed, and the postoperative period was uneventful. Histopathological analysis revealed a segmental GP. Discussion. GP is an uncommon entity, and its clinical and radiological presentation mimics PC. However, with advances in imaging tests, several radiological criteria have been described to distinguish GP from PC preoperatively. Although some authors recommend a stepwise management with initial conservative therapy, a therapeutic strategy has not yet been established. Conclusion. GP is an uncommon type of focal pancreatitis that should be considered as a differential diagnosis of PC. We report the first clinical case of GP whose debut with UGB presented a greater diagnostic and therapeutic challenge.

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Surgical management of groove pancreatitis: a case report

Cited by 4 publications

References 16 publications

Groove pancreatitis presenting with upper gastrointestinal obstruction and abnormal renal function: A case report and literature review

Groove pancreatitis presenting with upper gastrointestinal obstruction and abnormal renal function: A case report and literature review

Surgical Management of Groove Pancreatitis: A Case Report

Upper Gastrointestinal Bleeding as a Debut Form of Groove Pancreatitis: A Diagnostic Challenge

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