Upper Gastrointestinal Bleeding as a Debut Form of Groove Pancreatitis: A Diagnostic Challenge
Introduction. Groove pancreatitis (GP) is an unusual subtype of chronic pancreatitis that affects the groove area. Differential diagnosis between groove pancreatitis and pancreatic carcinoma (PC) can be challenging, both clinically and radiologically. Our aim is to report the first case of GP debut...
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| Language: | English |
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Wiley
2022-01-01
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| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2022/5562778 |
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| author | Belén Matías-García Camilo José Castellón-Pavón Gustavo Díaz-García Belén Manso-Abajo Daniel Hernández-Aceituno Antonio Hermosín-Peña Luis Mejías-Sosa Manuel Durán-Poveda |
| author_facet | Belén Matías-García Camilo José Castellón-Pavón Gustavo Díaz-García Belén Manso-Abajo Daniel Hernández-Aceituno Antonio Hermosín-Peña Luis Mejías-Sosa Manuel Durán-Poveda |
| author_sort | Belén Matías-García |
| collection | DOAJ |
| description | Introduction. Groove pancreatitis (GP) is an unusual subtype of chronic pancreatitis that affects the groove area. Differential diagnosis between groove pancreatitis and pancreatic carcinoma (PC) can be challenging, both clinically and radiologically. Our aim is to report the first case of GP debut with upper gastrointestinal bleeding (UGB). Case Report. A 53-year-old man with a personal history of alcohol and tobacco abuse and chronic pancreatitis was admitted to the hospital for epigastric abdominal pain. A computed tomography scan showed a locally advanced neoformative lesion in the distal stomach. The patient presented melena, arterial hypotension, and 4.4 g/dl of hemoglobin. An upper gastrointestinal endoscopy showed a neoformative ulcerated lesion at the duodenal bulb without active bleeding. Biopsies were taken, and histopathological analysis did not show malignancy. A cephalic pancreaticoduodenectomy was performed, and the postoperative period was uneventful. Histopathological analysis revealed a segmental GP. Discussion. GP is an uncommon entity, and its clinical and radiological presentation mimics PC. However, with advances in imaging tests, several radiological criteria have been described to distinguish GP from PC preoperatively. Although some authors recommend a stepwise management with initial conservative therapy, a therapeutic strategy has not yet been established. Conclusion. GP is an uncommon type of focal pancreatitis that should be considered as a differential diagnosis of PC. We report the first clinical case of GP whose debut with UGB presented a greater diagnostic and therapeutic challenge. |
| format | Article |
| id | doaj-art-863ac49e55274be58bbe12db195149bc |
| institution | Kabale University |
| issn | 2090-6919 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Surgery |
| spelling | doaj-art-863ac49e55274be58bbe12db195149bc2025-02-03T06:10:55ZengWileyCase Reports in Surgery2090-69192022-01-01202210.1155/2022/5562778Upper Gastrointestinal Bleeding as a Debut Form of Groove Pancreatitis: A Diagnostic ChallengeBelén Matías-García0Camilo José Castellón-Pavón1Gustavo Díaz-García2Belén Manso-Abajo3Daniel Hernández-Aceituno4Antonio Hermosín-Peña5Luis Mejías-Sosa6Manuel Durán-Poveda7General and Digestive Surgery Department of Príncipe de Asturias Teaching HospitalGeneral and Digestive Surgery Department of Rey Juan Carlos Teaching HospitalGeneral and Digestive Surgery Department of Rey Juan Carlos Teaching HospitalGeneral and Digestive Surgery Department of Rey Juan Carlos Teaching HospitalRadiology Department of Rey Juan Carlos Teaching HospitalInterventional Radiology Department of Rey Juan Carlos Teaching HospitalPathology Department of Rey Juan Carlos Teaching HospitalGeneral and Digestive Surgery Department of Rey Juan Carlos Teaching HospitalIntroduction. Groove pancreatitis (GP) is an unusual subtype of chronic pancreatitis that affects the groove area. Differential diagnosis between groove pancreatitis and pancreatic carcinoma (PC) can be challenging, both clinically and radiologically. Our aim is to report the first case of GP debut with upper gastrointestinal bleeding (UGB). Case Report. A 53-year-old man with a personal history of alcohol and tobacco abuse and chronic pancreatitis was admitted to the hospital for epigastric abdominal pain. A computed tomography scan showed a locally advanced neoformative lesion in the distal stomach. The patient presented melena, arterial hypotension, and 4.4 g/dl of hemoglobin. An upper gastrointestinal endoscopy showed a neoformative ulcerated lesion at the duodenal bulb without active bleeding. Biopsies were taken, and histopathological analysis did not show malignancy. A cephalic pancreaticoduodenectomy was performed, and the postoperative period was uneventful. Histopathological analysis revealed a segmental GP. Discussion. GP is an uncommon entity, and its clinical and radiological presentation mimics PC. However, with advances in imaging tests, several radiological criteria have been described to distinguish GP from PC preoperatively. Although some authors recommend a stepwise management with initial conservative therapy, a therapeutic strategy has not yet been established. Conclusion. GP is an uncommon type of focal pancreatitis that should be considered as a differential diagnosis of PC. We report the first clinical case of GP whose debut with UGB presented a greater diagnostic and therapeutic challenge.http://dx.doi.org/10.1155/2022/5562778 |
| spellingShingle | Belén Matías-García Camilo José Castellón-Pavón Gustavo Díaz-García Belén Manso-Abajo Daniel Hernández-Aceituno Antonio Hermosín-Peña Luis Mejías-Sosa Manuel Durán-Poveda Upper Gastrointestinal Bleeding as a Debut Form of Groove Pancreatitis: A Diagnostic Challenge Case Reports in Surgery |
| title | Upper Gastrointestinal Bleeding as a Debut Form of Groove Pancreatitis: A Diagnostic Challenge |
| title_full | Upper Gastrointestinal Bleeding as a Debut Form of Groove Pancreatitis: A Diagnostic Challenge |
| title_fullStr | Upper Gastrointestinal Bleeding as a Debut Form of Groove Pancreatitis: A Diagnostic Challenge |
| title_full_unstemmed | Upper Gastrointestinal Bleeding as a Debut Form of Groove Pancreatitis: A Diagnostic Challenge |
| title_short | Upper Gastrointestinal Bleeding as a Debut Form of Groove Pancreatitis: A Diagnostic Challenge |
| title_sort | upper gastrointestinal bleeding as a debut form of groove pancreatitis a diagnostic challenge |
| url | http://dx.doi.org/10.1155/2022/5562778 |
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