OBJECTIVES: This study aimed to evaluate the clinical and radiological features and clinical outcomes of paraduodenal pancreatitis (PP). METHODS: A final diagnosis of PP was based on surgical specimens in resected patients and on imaging in nonoperated patients. Clinical, radiological, and pathological data were collected and reevaluated. RESULTS: We studied 120 patients, 97.5% of whom were drinkers and 97.5% were smokers. Symptoms at clinical onset were acute pancreatitis in 78 patients (65%) and continuous pain in 68 patients (55.8%). Other symptoms were vomiting (36.7%), weight loss (25.8%), and jaundice (11.7%). Cystic variant was diagnosed in 82 patients (68.0%), and solid variant was diagnosed in 38 patients (32.0%). Pure and diffuse forms were observed in 22 (18.3%) and 98 (81.7%) patients, respectively. Pancreatic calcifications were present at clinical onset in 5.0% of the patients and in 61.0% at the end of follow-up. Somatostatin analogs were used in 13 patients (10.8%), and 81 patients (67.0%) underwent surgery. CONCLUSIONS: The clinical profile of PP was found to be middle-aged men who were heavy drinkers and smokers with painful pancreatitis and was associated with vomiting and weight loss. In nonresponders, alcohol withdrawal and medical therapy can be proposed as a first-line treatment, and surgery as a second-line treatment.
Our investigation suggests that MR imaging is accurate for identification of paraduodenal pancreatitis and for differentiation of this entity from ductal carcinoma of the pancreatic head.
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 extr...
Acute pancreatitis and chronic pancreatitis are complex inflammatory disorders of the pancreas with unpredictable severity, complications, and clinical courses. Growing evidence for genetic risk and modifying factors, plus strong evidence that only a minority of patients with these disorders are heavy alcohol drinkers, has revolutionized our concept of these diseases. Once considered a self-inflicted injury, pancreatitis is now recognized as a complex inflammatory condition like inflammatory bow...
Background Cystic dystrophy of heterotopic pancreas, groove pancreatitis, pancreatic hamartoma of the duodenum, paraduodenal wall cyst, and myoadenomatosis are all terms grouped together, from a pathological viewpoint, as definitions of paraduodenal pancreatitis (PP). The objective of the present study was to investigate the clinical characteristics, therapeutic strategies, and results in 58 patients undergoing pancreatic resection for PP.
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 spe...
Cystic dystrophy of heterotopic pancreas is a rare condition that means cystic changes of normal pancreatic tissue, placed in unusual locations, commonly in the duodenal wall. We report a case of CDHP in stomach, histologically confirmed after surgery. We show the correlation between radiological and anatomopathological findings, and also review the current literature about reported cases of this exceptional disease.
Objective Our purpose is to describe the MRI findings with pathologic correlation, in five patients with groove pancreatitis, a specific form of chronic pancreatitis affecting the groove between the pancreatic head, the common bile duct and duodenum.
Last. Krishna V. Menon(Leeds Teaching Hospitals NHS Trust)H-Index: 15
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Objectives. Groove pancreatitis (GP) describes a form of segmental pancreatitis, which affects the pancreatic head at the interface with the duodenum, and is frequently associated with ectopic pancreatic tissue in the duodenal wall. We present a series of symptomatic patients with complicated GP who underwent pancreaticoduodenectomy, and review the diagnostic challenges, imaging modalities, pathological features and clinical outcome of this rare condition. Patients and methods. This was a prospe...
BACKGROUND Cystic dystrophy in heterotopic pancreas (CDHP) is an uncommon complication of AND AIMS: pancreatic heterotopia, only described in surgical series, whose natural history is not known. The aim of this study was to determine clinical and morphological features of CDHP in a medical-surgical series of patients and to ascertain the relationship of CDHP with chronic pancreatitis (CP) in the pancreas proper. METHODS: All patients who had duodenal CDHP diagnosed radiologically both with CT sc...
Pancreas-preserving duodenal resections vs pancreatoduodenectomy for groove pancreatitis. Should we revisit treatment algorithm for groove pancreatitis?
#1Kohtaro Ooka(NYU: New York University)H-Index: 3
Last. Dhiraj Yadav(University of Pittsburgh)H-Index: 52
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Abstract Background & aims – The natural history of groove pancreatitis is incompletely characterized. Published literature suggests a high rate of surgery. We describe the short- and long-term outcomes in a cohort of patients with groove pancreatitis treated at our institution. Methods – Medical records of patients hospitalized in the University of Pittsburgh Medical Center system from 2000 to 2014 and diagnosed with groove pancreatitis based on imaging were retrospectively reviewed. Clinical p...
Paraduodenal pancreatitis (PP) is a rare type of focal pancreatitis involving the groove space. It mimics pancreatic head carcinoma, and its diagnosis and treatment are challenging. Pancreatoduodenectomy (PD) has traditionally been the primary surgical treatment for duodenal stenosis or suspected cancer.We herein report a case of PP in a 65-year-old man. The patient was admitted to the hospital for postprandial epigastric pain and vomiting. A low-density mass between the uncinate process of the ...
Abstract Background Painless chronic pancreatitis (CP) is a rare form of the disease. Aim To evaluate the prevalence and the characteristics of this overlooked form of pancreatitis. Methods Patients with a diagnosis of CP and absence of pain were selected, excluding patients suffering from autoimmune pancreatitis. Clinical data, imaging features, and exocrine and endocrine function were therefore analyzed. Results Among 781 patients observed between 2010 and 2016, 74 patients with painless CP (9...
Various inflammatory abnormalities of the pancreas can mimic pancreatic ductal adenocarcinoma (PDAC) at cross-sectional imaging. Misdiagnosis of PDAC at imaging may lead to unnecessary surgery. On the other hand, chronic pancreatitis (CP) bears a greater risk of developing PDAC during the course of the disease. Thus, differentiation between mass-forming chronic pancreatitis (MFCP) and PDAC is important to avoid unnecessary surgery and not to delay surgery of synchronous PDAC in CP. Imaging featu...
#1Irene Esposito(HHU: University of Düsseldorf)H-Index: 19
#1Irene Esposito(HHU: University of Düsseldorf)H-Index: 70
Last. Fiona Campbell(RLUH: Royal Liverpool University Hospital)H-Index: 55
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Abstract Background Chronic pancreatitis is a complex multifactorial fibro-inflammatory disease. Consensus guidelines are needed for the histopathological evaluation of non-autoimmune chronic pancreatitis (CP). Methods An international working group with experts on the histopathology of CP evaluated 15 statements generated from evidence on seven key clinically relevant questions. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to evaluate the leve...
Last. Claudio Bassi(University of Verona)H-Index: 110
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Abstract Background Paraduodenal pancreatitis is a focal form of chronic pancreatitis that affects the groove area between the duodenum and the head of the pancreas. Consensus regarding surgical or nonsurgical management as the best treatment option is still lacking. Methods We retrospectively evaluated all patients managed for PP at The Pancreas Institute of the University Hospital Trust of Verona from 1990 to 2017. The outcomes of surgical vs. medical treatment with regard to pain control, qua...
Absztrakt: A paraduodenalis, vagy groove pancreatitis egy kevesse ismert kronikus hasnyalmirigygyulladas-tipus, mely malignitast utanozva sokszor differencialdiagnosztikai nehezsegeket okoz. Kozlem...