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Groove Pancreatitis with Several Cystic Lesions around the Pancreatic Head Treated Conservatively: Report of a Case

Ito R, Shiba H, Okamoto T, Fujioka S, Gocho T, Yanaga K - Case Rep Gastroenterol (2008)

Bottom Line: A 61-year-old man was admitted to our hospital with epigastric pain and vomiting.Enhanced abdominal computed tomography revealed inflammatory change of the pancreatic groove and focal wall thickening of the second portion of the duodenum with several cystic lesions around the head of the pancreas.Groove pancreatitis is a rare form of chronic pancreatitis, and to the best of our knowledge, our patient is the first case in the English literature of groove pancreatitis with cystic lesions around the head of the pancreas, which disappeared after conservative treatment for pancreatitis.

Affiliation: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.

ABSTRACT

A 61-year-old man was admitted to our hospital with epigastric pain and vomiting. Enhanced abdominal computed tomography revealed inflammatory change of the pancreatic groove and focal wall thickening of the second portion of the duodenum with several cystic lesions around the head of the pancreas. We diagnosed atypical type of groove pancreatitis. The patient made a satisfactory recovery by conservative medication treatment for acute on chronic pancreatitis and cystic lesions disappeared in parallel with pancreatitis. Groove pancreatitis is a rare form of chronic pancreatitis, and to the best of our knowledge, our patient is the first case in the English literature of groove pancreatitis with cystic lesions around the head of the pancreas, which disappeared after conservative treatment for pancreatitis.

Abdominal enhanced CT revealed inflammatory change of the pancreatic groove (arrows) and focal wall thickening of the second portion of the duodenum with several cystic lesions (arrowheads).
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Figure 1: Abdominal enhanced CT revealed inflammatory change of the pancreatic groove (arrows) and focal wall thickening of the second portion of the duodenum with several cystic lesions (arrowheads).

Mentions: A 61-year-old man was urgently admitted to our hospital with severe epigastric pain and vomiting. The patient had a history of chronic pancreatitis from alcohol abuse and early gastric cancer treated four years earlier by segmental gastrectomy. Laboratory data were as follows: white blood cell count 16,200/mm3 with 74% neutrophils, serum amylase 298 IU/l, and serum C-reactive protein 9.5 mg/dl. Abdominal enhanced computed tomography (CT) revealed inflammatory change of the pancreatic groove (fig. 1, arrows) and focal wall thickening of the second portion of the duodenum with several cystic lesions around the head of the pancreas (fig. 1, arrowheads). Magnetic resonance cholangiopancreatography revealed a defect in the main pancreatic duct of the head and mild dilatation and irregularity of the distal pancreatic duct, which suggested protein plug. The biliary tree did not show abnormality. Upper gastrointestinal endoscopy revealed stenosis of the supraampullary area of the duodenum and erosive change of duodenal mucosa. Histological examination by endoscopic biopsy revealed inflammatory change of the duodenal mucosa without malignant findings. The patient was diagnosed with acute on chronic, atypical type of groove pancreatitis with duodenal wall thickening and several cystic lesions around the head of the pancreas.

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Groove Pancreatitis with Several Cystic Lesions around the Pancreatic Head Treated Conservatively: Report of a Case

Ito R, Shiba H, Okamoto T, Fujioka S, Gocho T, Yanaga K - Case Rep Gastroenterol (2008)

Abdominal enhanced CT revealed inflammatory change of the pancreatic groove (arrows) and focal wall thickening of the second portion of the duodenum with several cystic lesions (arrowheads).
© Copyright Policy
Figure 1: Abdominal enhanced CT revealed inflammatory change of the pancreatic groove (arrows) and focal wall thickening of the second portion of the duodenum with several cystic lesions (arrowheads).
Mentions: A 61-year-old man was urgently admitted to our hospital with severe epigastric pain and vomiting. The patient had a history of chronic pancreatitis from alcohol abuse and early gastric cancer treated four years earlier by segmental gastrectomy. Laboratory data were as follows: white blood cell count 16,200/mm3 with 74% neutrophils, serum amylase 298 IU/l, and serum C-reactive protein 9.5 mg/dl. Abdominal enhanced computed tomography (CT) revealed inflammatory change of the pancreatic groove (fig. 1, arrows) and focal wall thickening of the second portion of the duodenum with several cystic lesions around the head of the pancreas (fig. 1, arrowheads). Magnetic resonance cholangiopancreatography revealed a defect in the main pancreatic duct of the head and mild dilatation and irregularity of the distal pancreatic duct, which suggested protein plug. The biliary tree did not show abnormality. Upper gastrointestinal endoscopy revealed stenosis of the supraampullary area of the duodenum and erosive change of duodenal mucosa. Histological examination by endoscopic biopsy revealed inflammatory change of the duodenal mucosa without malignant findings. The patient was diagnosed with acute on chronic, atypical type of groove pancreatitis with duodenal wall thickening and several cystic lesions around the head of the pancreas.

Bottom Line: A 61-year-old man was admitted to our hospital with epigastric pain and vomiting.Enhanced abdominal computed tomography revealed inflammatory change of the pancreatic groove and focal wall thickening of the second portion of the duodenum with several cystic lesions around the head of the pancreas.Groove pancreatitis is a rare form of chronic pancreatitis, and to the best of our knowledge, our patient is the first case in the English literature of groove pancreatitis with cystic lesions around the head of the pancreas, which disappeared after conservative treatment for pancreatitis.

Affiliation: Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.

ABSTRACT

Background: A 61-year-old man was admitted to our hospital with epigastric pain and vomiting. Enhanced abdominal computed tomography revealed inflammatory change of the pancreatic groove and focal wall thickening of the second portion of the duodenum with several cystic lesions around the head of the pancreas. We diagnosed atypical type of groove pancreatitis. The patient made a satisfactory recovery by conservative medication treatment for acute on chronic pancreatitis and cystic lesions disappeared in parallel with pancreatitis. Groove pancreatitis is a rare form of chronic pancreatitis, and to the best of our knowledge, our patient is the first case in the English literature of groove pancreatitis with cystic lesions around the head of the pancreas, which disappeared after conservative treatment for pancreatitis.

View Similar Images In: Results  - Collection
View Article: Pubmed Central -  PubMed
Show All Figures - Show MeSH
getmorefigures.php?pmc=3166802&rFormat=json&query=null&req=5