Groove pancreatitis and how to differentiate it from pancreatic adenocarcinoma.

Groove pancreatitis is an uncommon type of chronic pancreatitis that affects the space between the head of the pancreas, the second portion of the duodenum, and the common bile duct. The main trigger is chronic alcohol abuse, which eventually leads to leakage of pancreatic juices into the pancreaticoduodenal groove, causing inflammation and fibrosis. The main differential diagnosis is with pancreatic adenocarcinoma, which is more common than groove pancreatitis. Different imaging techniques make it possible to identify various findings (e.g., duodenal thickening or duodenal and paraduodenal cysts, which are characteristic of groove pancreatitis) that sometimes enable differentiation between groove pancreatitis and other entities, although there are no specific findings for each of them. Sometimes biopsy or surgery is required to establish the definitive diagnosis. The treatment of groove pancreatitis is usually conservative, but in cases in which the symptoms do not improve, interventional procedures (biliary drainage) or surgery (Whipple technique) can be done.

Revisión de la pancreatitis del surco y cómo diferenciarla del adenocarcinoma de páncreas / Groove pancreatitis and how to differentiate it from pancreatic adenocarcinoma

La pancreatitis del surco es un tipo poco frecuente de pancreatitis crónica que afecta al espacio comprendido entre la cabeza del páncreas, la segunda porción duodenal y el colédoco. El consumo crónico de alcohol se ha descrito como el principal factor desencadenante, cuyo resultado final es la fuga de secreciones pancreáticas al surco pancreatoduodenal, con la consecuente afectación fibroinflamatoria en dicha localización. El principal diagnóstico diferencial de la pancreatitis del surco es el adenocarcinoma de páncreas, siendo este último más frecuente.Gracias a la disponibilidad de las diferentes técnicas de imagen, es posible identificar varios hallazgos radiológicos que permiten distinguir, a veces, ambas entidades, como son el engrosamiento duodenal o la presencia de quistes duodenales y paraduodenales (característicos de la pancreatitis del surco), aunque no existen hallazgos específicos para cada una de ellas. En ocasiones es necesario recurrir a la toma de biopsia o cirugía para establecer un diagnóstico definitivo.El tratamiento de la pancreatitis del surco suele ser conservador, pero en casos en los que no hay mejoría de los síntomas se realizan procedimientos intervencionistas (drenaje biliar) o cirugía (duodenopancreatectomía cefálica). (AU)

Groove pancreatitis is an uncommon type of chronic pancreatitis that affects the space between the head of the pancreas, the second portion of the duodenum, and the common bile duct. The main trigger is chronic alcohol abuse, which eventually leads to leakage of pancreatic juices into the pancreaticoduodenal groove, causing inflammation and fibrosis. The main differential diagnosis is with pancreatic adenocarcinoma, which is more common than groove pancreatitis.Different imaging techniques make it possible to identify various findings (e.g., duodenal thickening or duodenal and paraduodenal cysts, which are characteristic of groove pancreatitis) that sometimes enable differentiation between groove pancreatitis and other entities, although there are no specific findings for each of them. Sometimes biopsy or surgery is required to establish the definitive diagnosis.The treatment of groove pancreatitis is usually conservative, but in cases in which the symptoms do not improve, interventional procedures (biliary drainage) or surgery (Whipple technique) can be done. (AU)