Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2019; 7(23): 4106-4110
Published online Dec 6, 2019. doi: 10.12998/wjcc.v7.i23.4106
Complete duodenal obstruction induced by groove pancreatitis: A case report
Ya-Li Wang, Chen-Hao Tong, Jian-Hua Yu, Zhi-Liang Chen, Hong Fu, Jian-Hui Yang, Xin Zhu, Bao-Chun Lu
Ya-Li Wang, Chen-Hao Tong, Jian-Hua Yu, Zhi-Liang Chen, Hong Fu, Jian-Hui Yang, Xin Zhu, Bao-Chun Lu, Department of Hepatobiliary Surgery, Shaoxing People’s Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing 312000, Zhejiang Province, China
Author contributions: Wang YL and Tong CH contributed equally to this work. Wang YL, Tong CH, and Yu JH wrote the manuscript; Lu BC, Chen ZL, and Fu H were the surgeons for the patient; Yang JH and Zhu X looked after the patient.
Supported by National Natural Science Foundation of China, No. 81602044; Zhejiang Provincial Natural Science Foundation of China, No. LY19H160016 and No. LY17H030001; Zhejiang Provincial Public Welfare Technology Application Research Projects, No. 2015C33293; and Research Foundation of Health Bureau of Zhejiang Province, No. 2014RCA031, No. 2018RC077, No. 2015KYA218, and No. 2016KYB300.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: There are some conflicts in funding. Authors obtained the grant support from National Natural Science Foundation of China; Zhejiang Provincial Natural Science Foundation of China; Zhejiang Provincial Public Welfare Technology Application Research Projects; and Research Foundation of Health Bureau of Zhejiang Province.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Bao-Chun Lu, MD, MSc, Chief Doctor, Department of Hepatobiliary Surgery, Shaoxing People’s Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), 568 North Zhongxing Road, Shaoxing 312000, Zhejiang Province, China. sygd_lbc@126.com
Telephone: +86-575-88228828
Received: September 27, 2019
Peer-review started: September 27, 2019
First decision: October 24, 2019
Revised: November 8, 2019
Accepted: November 15, 2019
Article in press: November 15, 2019
Published online: December 6, 2019
Processing time: 70 Days and 3.2 Hours
Abstract
BACKGROUND

Groove pancreatitis (GP) is a type of chronic pancreatitis occurring in an anatomic area between the duodenum, head of the pancreas, and common bile duct. Duodenal obstruction is always caused by malignant pancreatic diseases, such as pancreatic head carcinoma, while is rarely induced by benign pancreatic diseases, such as pancreatitis.

CASE SUMMARY

A 39-year-old man presented with a 1-mo history of upper abdominal discomfort. His concomitant symptoms were abdominal distension, postprandial nausea, and vomiting. Contrast-enhanced computed tomography of the abdomen showed thickening of the intestinal wall with enhancement of the descending segment of the duodenum, which could not be clearly differentiated from the head of the pancreas. Upper gastrointestinal radiographs and gastrointestinal endoscopy showed a complete obstruction of the descending duodenum. An operation found that a 3-cm mass was located in the “groove part” of the pancreas and oppressing the descending duodenum. Pancreaticoduodenectomy was performed to relieve the obstruction and thoroughly remove the pancreatic lesions. The pathologic diagnosis was pancreatitis. The patient had an uneventful recovery with no complications.

CONCLUSION

Because of the special location and the contracture induced by long-term chronic inflammation, our case reminds surgeons that some benign pancreatic diseases, such as GP, can also present with symptoms similar to those of pancreatic cancer. This knowledge can help to avoid an unnecessary radical operation.

Keywords: Groove pancreatitis; Duodenal obstruction; Pancreatic head carcinoma; Case report

Core tip: Duodenal obstruction is always caused by malignant pancreatic diseases, such as pancreatic head carcinoma. Here, we report a case of complete duodenal obstruction which was caused by groove pancreatitis, a benign pancreatic disease. This case reminds surgeons that some benign pancreatic diseases, such as groove pancreatitis, can also present with symptoms similar to those of pancreatic cancer, and this knowledge can help to avoid an unnecessary radical operation.