Learning objectives
1.
Identify the anatomic potential space,
the pancreaticoduodenal (PD) groove.
2.
Discuss and classify the range of pathological conditions that can present with imaging abnormalities in the region.
3.
Describe,
with illustrated examples,
a range of cases encountered in our clinical practice.
Background
The PD groove is a potential space which is bordered anteriorly by the first part of the duodenum,
laterally by the second part and posteriorly by the third part of the duodenum or inferior vena cava.
It is bordered medially by the head of the pancreas Fig. 1and Fig. 2.
The common bile duct traverses it,
and it contains fat and some small lymph nodes.
Imaging findings OR Procedure details
Diseases of the PD groove can be classified by their origin,
relating to the surrounding structures.
Disease processes of the pancreas,
duodenum,
lymph nodes,
common bile duct and disease processes extending into the groove from elsewhere.
1.Pancreas
Acute pancreatitis,
Fig. 3
Acutepancreatitis involving the PD groove is different from groove pancreatitis.
It is characterised by inflammatory change and fluid in the PD groove that changes over time.
The remainder of the pancreas is normal in appearance.
Groove pancreatitis Fig. 4,
Fig. 5,
Fig. 6
Groove...
Conclusion
The PD groove is a potential space,
which can contain pathology from its surrounding structures or invasion from elsewhere.
This exhibit has classified these differentials and provides,
with illustrated examples,
a framework for distinguishing between them.
References
Yu J,
Fulcher AS,
Turner MA,
Halvorsen RA.
Normal anatomy and disease processes of the pancreatoduodenal groove: imaging features.AJR Am J Roentgenol.2004;183:839–846.
Irie H,
Honda H,
Kuroiwa T,
et al.
MRI of groove pancreatitis.
J Comput Assist Tomogr1998 ;22:651 -655
Itoh S,
Yamakawa K,
Shimamoto K,
Endo T,
Ishigaki T.
CT findings in groove pancreatitis: correlation with histopathological findings.
J Comput Assist Tomogr 1994;18:911 -915
Stolte M,
Weiss W,
Volkholz H,
Rosch W.
A special form of segmental pancreatitis: groove pancreatitis.