J Med Assoc Thai 2009; 92 (11):1554

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Groove Pancreatitis: Report of One Case in Thailand
Meesiri S Mail

Groove pancreatitis is a rare form of chronic pancreatitis affecting the head of the pancreas localized
within the pancreatoduodenal groove. Fibrous scar in this specific topography sometimes makes it hard to
differentiate from pancreatic cancer preoperatively. The author reports the case of a 44-year-old man with a
long history of alcoholic abuse and experienced intermittent epigastric and nausea vomiting for 2 years.
Abdominal ultrasound showed an irregular mixed echogenic mass at the pancreatic head. A computed
tomography revealed a poorly enhanced solid mass with small low density cystic areas in the groove, thickening
and luminal narrowing of the descending part of the duodenum. Magnetic resonance imaging demonstrated
the same mass that was hypointense on T1 weighted images, isointense on T2 weighted images and delayed,
progressive inhomogeneous enhancement on dynamic contrast study. MRCP defined a prominent smooth
tapering of the common bile duct. Endoscopy disclosed an inflammed sessile mass at the second part of the
duodenum. Microscopic examination of the biopsy specimens suggested only chronic inflammation. Then, the
patient was treated conservatively and evaluated periodically.

Keywords: Groove pancreatitis, Brunner’s gland, Santorini’s duct

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