Type:
Educational Exhibit
Keywords:
Abdomen, Pancreas, CT, Ultrasound, MR, Diagnostic procedure, Inflammation
Authors:
A. Arora1, V. Bhatia2, A. Mukund1, A. Dev1, Y. Patidar3, S. T. Laroia1, S. K. Sarin1; 1New Delhi/IN, 2New Delhi /IN, 3Madhya Pradesh/IN
DOI:
10.1594/ecr2013/C-1131
Conclusion
The terms ‘cystic dystrophy of heterotopic pancreas,’ ‘groove pancreatitis,’ ‘pancreatic hamartoma of duodenum,’ ‘paraduodenal wall cyst’ and ‘myoadenomatosis’ are now classified as Paraduodenal Pancreatitis.
These patients have clinical characteristics similar to those of chronic pancreatitis.
Diagnostic imaging modalities of choice are endoscopic ultrasonography and MRI with MRCP,
and,
the characteristic imaging findings include a solid or cystic pattern corresponding to the path of the duct of Santorini/minor papilla (groove region) with thickening of the duodenal wall.
A painful solid and/or cystic lesion along the pancreatic groove,
in a man 40-50 years of age with a significant history of alcohol consumption and tobacco use should lead the radiologist to consider the presence of this entity.
Awareness of the possibility that a paraduodenal solid/cystic lesion on imaging could represent paraduodenal pancreatitis should influence the radiologist to avoid mislabelling the entity as an ominous pancreatic or periampullary carcinoma.
Conversely,
before making the diagnosis of paraduodenal pancreatitis,
the possibility of malignancy should be carefully excluded.