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Case Reports
. 2024 May 16;16(5):e60471.
doi: 10.7759/cureus.60471. eCollection 2024 May.

Navigating the Groove: A Unique Case of Groove Pancreatitis

Oshin Rai  1 , Anvit D Reddy  1 , Vanshika Tripathi  1 , Natalie Shaykh  1 , Noor Marji  2 , Ghania Masri  1 , Bruno Ribeiro  3
Affiliations
Case Reports

Navigating the Groove: A Unique Case of Groove Pancreatitis

Oshin Rai et al. Cureus. .

Abstract

Groove pancreatitis (GP) is an uncommon form of chronic pancreatitis (CP) that affects the area between the duodenum, the head of the pancreas, and the common bile duct (CBD), which is known as the pancreaticoduodenal groove. Our case is based on a 68-year-old male with a past medical history of alcohol use disorder and a 50-pack-year smoking history who presented with nausea, vomiting, and poor oral intake. Computed tomography (CT) of the abdomen and pelvis showed gastric outlet obstruction due to a 6.0 cm mass in the pancreatic groove and the second portion of the duodenum, with dilation of the pancreatic, intrahepatic, and extrahepatic biliary ducts. In order to rule out malignancy and evaluate the acute symptoms, the patient underwent an open pancreaticoduodenectomy (PD). Pathologic findings and negative tumor markers confirmed GP. This case highlights a rare form of CP that symptomatically and radiographically mimics malignancy, but is benign.

Keywords: chronic pancreatitis; groove pancreatitis; hemangioma; paraduodenal pancreatitis; whipple’s pancreaticoduodenectomy.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Computed tomography of the abdomen and pelvis showing a pancreatic mass measuring grossly 5.6 cm x 4.6 cm in the anterior-posterior view or transverse plane.
Figure 2
Figure 2. Computed tomography of the abdomen and pelvis showing a pancreatic mass measuring grossly 5.6 cm in the coronal plane.
Figure 3
Figure 3. Chronic pancreatitis evidenced by heavy calcification on computed tomography of the abdomen and pelvis.
Figure 4
Figure 4. Computed tomography of the abdomen and pelvis showing dilation of the pancreatic duct, approximately 1.3 cm.
Figure 5
Figure 5. Computed tomography of the abdomen and pelvis showing a hepatic lesion, measuring 1.36 cm.
Figure 6
Figure 6. Groove pancreatitis (paraduodenal pancreatitis) showing pseudocysts (lined by granulation tissue) of the duodenal wall, fibrosis, and chronic inflammation.
Figure 7
Figure 7. High-power view of the pseudocyst which showed granulation tissue and stone fragments (blue arrow).
Figure 8
Figure 8. Brunner gland hyperplasia.
See this image and copyright information in PMC

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