A.I. Burnasyan FMBC clinical bulletin. 2025 № 2
Yu.S. Pyshkina1, N.G. Ushakov2, M.Sh. Rozakov1,2
Paraduodenal Pancreatitis (a Case Report)
1Samara State Medical University, Samara, Russia
2State budgetary healthcare institution of the Samara Region “Samara City Clinical Hospital №. 8”, Samara, Russia
Contact person: Pyshkina Yuliya Sergeevna: yu.pyshkina@yandex.ru
Abstract
Purpose: to demonstrate a clinical case of a rare form of chronic local pancreatitis – paraduodenal pancreatitis – in a patient presenting with acute abdominal pathology symptoms.
Materials and methods: pancreatitis of the groove, or paraduodenal pancreatitis, is a rare form of chronic segmental pancreatitis, located between the head of the pancreas, the inner wall of the duodenum, and the common bile duct. The main differential diagnosis is pancreatic carcinoma, which sometimes requires surgical exploration. There are two main histological variants of paraduodenal pancreatitis – cystic and solid – each with slightly different imaging characteristics. The diagnosis is made on the basis of computed tomography and magnetic resonance imaging data. Additionally, the imaging results may change over time due to disease progression or risk factors such as alcohol consumption and smoking. Clinical signs usually regress under symptomatic medical treatment. The primary differential diagnosis is pancreatic carcinoma, which sometimes necessitates surgical exploration. We report the case of a 42 years old man presenting paraduodenal pancreatitis with featuring heterotopic pancreatic tissue, identified during epigastric pain evaluation. To establish the diagnosis, the patient underwent plain X-rays of the abdomen, abdominal ultrasound, fibrogastroduodenoscopy, contrast-enhanced multispiral computed tomography of the abdomen, and surgery.
Results: tnhanced X-ray computed tomography revealed pancreatic calcification, dilation of the main pancreatic and Santorini’s ducts, cystic transformation of the descending part of the duodenum extending into the bulb, thickening of the duodenal wall, and its narrowing.
Conclusion: analysis of the literature and our clinical observation highlight the complexity of diagnosing paraduodenal pancreatitis. Therefore, a thorough understanding of the radiographic signs of this poorly studied disease is crucial for accurate diagnosis, enabling optimal patient management strategies.
Keywords: paraduodenal pancreatitis, pancreas, computed tomography, tomography, radiation diagnostic
For citation: Pyshkina YuS, Ushakov NG, Rozakov MSh. Paraduodenal Pancreatitis (a Case Report)s. A.I. Burnasyan Federal Medical Biophysical Center Clinical Bulletin. 2025.2:46-51. (In Russian) DOI: 10.33266/2782-6430-2025-2-46-51
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Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship. Участие авторов.
Contribution. Article was prepared with equal participation of the authors.
Article received: 11.01.2025. Accepted for publication: 15.02.2025