Indian Journal of Radiology Indian Journal of Radiology  

   Login   | Users online: 697

Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size     

 

ABDOMINAL RADIOLOGY Table of Contents   
Year : 2015  |  Volume : 25  |  Issue : 3  |  Page : 303-314
Clinicoradiological appraisal of 'paraduodenal pancreatitis': Pancreatitis outside the pancreas!


1 Department of Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
2 Department of Hepato-pancreatico-biliary surgery, Institute of Liver and Biliary Sciences, New Delhi, India
3 Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India

Correspondence Address:
Assoc. Prof. Ankur Arora
Department of Radiology, Institute of Liver and Biliary Sciences, D-1 Vasant Kunj, New Delhi - 110 070
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-3026.161467

Rights and Permissions

Purpose: Paraduodenal pancreatitis (PP) is a unique form of focal chronic pancreatitis that selectively involves the duodenum and aberrant pancreatic tissue located near the minor papilla (beyond the pancreas proper). The pseudotumoral nature of the disease often generates considerable clinical quandary and patient apprehension, and therefore merits a better understanding. The present study appraises the clinicoradiological manifestations of PP in 33 patients. Materials and Methods: Clinical, laboratory, and radiological manifestations of 33 patients of PP treated in gastroenterology/hepatology and hepato-pancreatico-biliary surgery units during June 2010-August 2014 were retrospectively reviewed. Results: All patients were young to middle-aged men (100%) with history of alcohol abuse (93.9%) and/or smoking (42.4%), who presented either with acute or gradually worsening abdominal pain (90.9%). Pancreatic enzymes and serum tumor markers remained normal or were mildly/transiently elevated. Cystic variant was detected in 57.6% (solid in 42.4%); the disease remained confined to the groove/duodenum (pure form) in 45.4%. Medial duodenal wall thickening with increased enhancement was seen in 87.87 and 81.81%, respectively, and duodenal/paraduodenal cysts were seen in 78.78%. Pancreatic calcifications and biliary stricture were seen 27.3% patients. Peripancreatic arteries were neither infiltrated nor encased. Conclusion: PP has a discrete predilection for middle-aged men with history of longstanding alcohol abuse and/or smoking. Distinguishing imaging findings include thickening of the pancreatic side of duodenum exhibiting increased enhancement with intramural/paraduodenal cysts. This may be accompanied by plate-like scar tissue in the groove region, which may simulate groove pancreatic carcinoma. However, as opposed to carcinoma, the peripancreatic arteries are neither infiltrated nor encased, rather are medially displaced.


[FULL TEXT] [PDF]*
Print this article     Email this article

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
  Citation Manager
 Access Statistics
  Reader Comments
  Email Alert *
  Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed5456    
    Printed69    
    Emailed2    
    PDF Downloaded635    
    Comments [Add]    

Recommend this journal