Groove pancreatitis treated by duodenal and biliary bypass

Abstract

Background: Groove pancreatitis is a type of pancreatitis where inflammation occurs in the “groove area” which is the narrow space surrounded by the duodenum, head of the pancreas and common bile duct, where lymph nodes, blood vessels and pancreatic duct exist. Groove area inflammation causes duodenal stenosis/obstruction, narrowing of the extrahepatic biliary tree and sometimes pancreatitis. The exact etiology of the disease is not well understood but Santorini duct obstruction (congenital or acquired) may be associated with inflammation of the groove area, which is partly caused by excessive alcoholic intake or gastric/duodenal peptic ulcer in adults. Case presentation: We report a very rare pediatric case of groove pancreatitis. The imaging findings were typical for groove pancreatitis and the bypass operation to release duodenal stenosis and extrahepatic biliary tree obstruction was performed instead of doing pancreaticoduodenectomy often done in adult cases. Conclusion: Groove pancreatitis is a rare disorder and a pediatric case is quite rare but pediatric surgeons should keep in mind this rare disorder when we meet the case with biliary dilatation and/or duodenal stenosis.

Keywords

• Groove pancreatitis
• Duodenal stenosis
• Pancreaticoduodenectomy