Tu1295 Paraduodenal Pancreatitis: An Italian Experience on 112 Patients

Pretis, Nicolò de; Amodio, Antonio; Marchi, Giulia De; Messina, O.; Davì, V.; Granato, Anna; Gabbrielli, Armando; Benini, Luigi; Frulloni, Luca

doi:10.1016/s0016-5085(14)62913-9

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“…[ 25 ] Based upon the predominance of the solid scar tissue or cystic lesions, two variants of PP have been described: (1) The “cystic” type showing multiple paraduodenal and/or duodenal wall cysts which may protrude into the duodenal lumen and (2) the “solid” type characterized by a marked medial duodenal wall thickening with a sheet-like solid mass in the groove [ Figure 7 ]. [ 5 ] Pretis et al , in their series of 112 patients, reported cystic variant in 79 (70%) patients and solid type in 33 (30%) patients,[ 30 ] whereas of the 33 patients in the present study, the disease was predominantly cystic in 19 (57.6%) and the remaining 14 patients exhibited a predominantly solid variant (42.4%).…”

Section: Discussioncontrasting

confidence: 54%

“…Pancreatic calcifications were observed in 68 (61%) patients. [ 30 ] More recently, Zaheer et al , reported pancreatic duct dilatation in 8 of their 12 patients (66.66%), calcifications localized to the head in 4 (33%), diffuse calcification in 1 (8.33%), and pancreatic glandular atrophy in 3 (25%) patients. [ 31 ] Twelve of our 33 (36.3%) patients showed pancreatic parenchymal atrophy, while 10 (30.3%) patients showed pancreatic calcifications and as many as 18 (54.54%) patients showed main pancreatic duct dilatation.…”

Section: Discussionmentioning

confidence: 99%

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Clinicoradiological appraisal of ′paraduodenal pancreatitis′: Pancreatitis outside the pancreas!

Arora

Rajesh

Mukund

et al. 2015

Indian Journal of Radiology and Imaging

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Purpose:Paraduodenal pancreatitis (PP) is a unique form of focal chronic pancreatitis that selectively involves the duodenum and aberrant pancreatic tissue located near the minor papilla (beyond the pancreas proper). The pseudotumoral nature of the disease often generates considerable clinical quandary and patient apprehension, and therefore merits a better understanding. The present study appraises the clinicoradiological manifestations of PP in 33 patients.Materials and Methods:Clinical, laboratory, and radiological manifestations of 33 patients of PP treated in gastroenterology/hepatology and hepato-pancreatico-biliary surgery units during June 2010-August 2014 were retrospectively reviewed.Results:All patients were young to middle-aged men (100%) with history of alcohol abuse (93.9%) and/or smoking (42.4%), who presented either with acute or gradually worsening abdominal pain (90.9%). Pancreatic enzymes and serum tumor markers remained normal or were mildly/transiently elevated. Cystic variant was detected in 57.6% (solid in 42.4%); the disease remained confined to the groove/duodenum (pure form) in 45.4%. Medial duodenal wall thickening with increased enhancement was seen in 87.87 and 81.81%, respectively, and duodenal/paraduodenal cysts were seen in 78.78%. Pancreatic calcifications and biliary stricture were seen 27.3% patients. Peripancreatic arteries were neither infiltrated nor encased.Conclusion:PP has a discrete predilection for middle-aged men with history of longstanding alcohol abuse and/or smoking. Distinguishing imaging findings include thickening of the pancreatic side of duodenum exhibiting increased enhancement with intramural/paraduodenal cysts. This may be accompanied by plate-like scar tissue in the groove region, which may simulate groove pancreatic carcinoma. However, as opposed to carcinoma, the peripancreatic arteries are neither infiltrated nor encased, rather are medially displaced.

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Section: Discussioncontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 99%