Abstract

Groove pancreatitis (GP) is often diagnosed in middle-aged alcoholic men presenting nausea, vomiting, upper abdominal pain and jaundice due to common bile duct stricture and duodenal stricture. Due to the absence of ultrasonographic and radiographic evidence of cancer and no definitive criteria for pre-operative diagnosis, diagnostic imaging is helpful to distinguish GP and pancreatic cancer. An intraoperative histologic examination using frozen sections may provide useful information. Etiology is not yet elucidated. Currently, two types of research approach have reported on the etiopathogenetic possibilities of this type of pancreatitis: inflammatory process of the duodenal wall, and around Santorini's duct. By histologic examination using paraffin sections of the pancreas, common bile duct and duodenum, GP should be confirmed after surgery. ERCP shows narrowing of the intrapancreatic common bile duct. Ultrasonography, CT and MRI demonstrates a mass lesion in the pancreas head. Preoperative diagnostic criteria may help to make a correct diagnosis of GP.

Copyright © 2007 S. Karger AG, Basel

The anatomic space between the head of the pancreas, the right lateral and lower borders, and the duodenum is called a groove, where the common bile duct descends behind and where the anastomosing superior and inferior pancreaticoduodenal arteries run. Groove pancreatitis (GP) is defined as a special form of pancreatitis, arising in the groove. Scarring is mainly found in GP.

In 1973, Becker et al. [1] reported 117 cases of GP, first reported in German as 'Rinnenpankreas', from 600 resected pancreata. In terms of pathomorpholog-ical characteristics, they distinguished between (1) pure GP, (2) segmental pancreatitis of the head with groove involvement and (3) chronic homogeneous pancreatitis with groove involvement. In 1983, Stolte et al. [2] reported 30 cases of GP in 123 cases of chronic pancreatitis. They distinguished between pure and segmental GP. In pure GP, no fibrosis of the pancreatic parenchyma is seen, and in segmental GP, both pancreas and groove are affected.

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