scholarly journals GROOVE PANCREATITIS MASQUERADING AS CARCINOMA PANCREAS : A DIAGNOSTIC DILEMMA

2020 ◽  
pp. 1-2
Author(s):  
Lohith P ◽  
Rajshekar P ◽  
Deepak Ghuliani ◽  
Ravindra K Saran
Keyword(s):  
Pancreatic Cancer ◽  
Chronic Pancreatitis ◽  
Duodenal Obstruction ◽  
Signs And Symptoms ◽  
Duodenal Wall ◽  
Management Approach ◽  
Clinical Response Rate ◽  
Diagnostic Dilemma ◽  
Groove Pancreatitis ◽  
Whipple’S Procedure

INTRODUCTION: Groove pancreatitis(GP) is a rare special form of chronic pancreatitis localised to pancreaticoduodenal groove, presents commonly with signs and symptoms of duodenal obstruction, mimicks pancreatic cancer radiologically and the surgeon proceeds with inadvertent whipples procedure. PRESENTATION OFCASE: A28yr old gentleman, alcoholic presented with duodenal obstruction for 3days. CECTabdomen was suggestive of exophytic lesion from second part of duodenum ?duodenal diverticulum. UGIE showed large growth with overlying abnormal mucosa causing luminal compromise in second part of duodenum. Biopsy was taken which showed normal villous pattern. Patient was managed conservatively and improved gradually. On further evaluation, EUS showed 5×5.5cm cystic space occupying lesion in close relation to second part of duodenum and head of pancreas ?origin. EUS guided FNAC showed features suggestive of adenocarcinoma. With this pathological diagnosis, patient was taken up for Whipple's procedure, intraoperatively, 3cm mass lesion was noted in the pancreaticoduodenal groove. HPE of the specimen showed a haemorraghic nodule (3×1.8×1.2cm) in the duodenal wall and changes of chronic pancreatitis in the pancreticoduodenal groove suggestive of GP. Postoperative period and follow up of 6 months was uneventful. DISCUSSION: In GP, EUS guided FNAC may reveal large gaint cells, spindle cells or hyperplasia of brunner glands depending on the area of sampling and these features mimic neoplasia as observed in our case. MRI criteria given by Kalb et al show diagnostic accuracy of 87.2% for GP and negative predictive value of 92.9% to rule out pancreatic cancer. Arvanitakis et al showed stepwise management approach is effective in GP and with combination of medical and endoscopic treatment, complete clinical response rate was observed in 80%. CONCLUSION: It is important to diagnose and differentiate GP from pancreatic cancer preoperatively and avoid morbidity from unnecessary pancreaticoduodenectomy in patients of GP.

Pancreatitis crónica del surco pancreatoduoenal: un desafío diagnóstico y terapéutico. Reporte de un caso

2020 ◽  
Vol 50 (2) ◽  
Author(s):  
Claudio Murillo Matamoros ◽  
Marta Muñiz Muñoz ◽  
Miguel Suárez Matías ◽  
Pablo Olcina Domínguez ◽  
Laura Valiente González ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Endoscopic Ultrasound ◽  
Duodenal Obstruction ◽  
Imaging Techniques ◽  
Definitive Diagnosis ◽  
Duodenal Wall ◽  
Complex Anatomy ◽  
History Of ◽  
Uncertain Etiology

Groove pancreatitis is a very uncommon type of chronic pancreatitis of uncertain etiology that occurs in the pancreatoduodenal groove. Despite the great advances in imaging techniques, making a definitive diagnosis is difficult because of the complex anatomy of this area. Therefore, surgical treatment is often required due to the impossibility of excluding malignancy. We present the case of a patient with a history of chronic pancreatitis admitted due to duodenal obstruction. The diagnosis was difficult, especially for the need to exclude the neoplasms of the duodenal-pancreatic area. Endoscopic ultrasound was essential to establish a definitive diagnosis, allowing FNAP and correct assessment of the duodenal wall.

scholarly journals Diagnostic Dilemma in Groove Pancreatitis: A Case Report

2020 ◽  
Vol 58 (231) ◽  
Author(s):  
Uttam Laudari ◽  
Roshan Ghimire ◽  
Rosi Pradhan ◽  
Dhiresh Kumar Maharjan ◽  
Prabin Bikram Thapa
Keyword(s):  
Case Report ◽  
Chronic Pancreatitis ◽  
Ductal Adenocarcinoma ◽  
Diagnostic Dilemma ◽  
Perioperative Morbidity ◽  
Persistent Symptoms ◽  
Groove Pancreatitis ◽  
History Of ◽  
High Index Of Suspicion

Groove pancreatitis is uncommon form of chronic pancreatitis common in patients with history of smoking and alcohol abuse. High index of suspicion is required as it may masquerade pancreatic ductal adenocarcinoma and both of these conditions are difficult to differentiate preoperatively. Pancreaticoduodenectomy has good outcome in patient with Groove pancreatitis. Hence, we are reporting a case report of Groove pancreatitis in 40 years gentleman, who was being managed by multiple endoscopic dilatations, later underwent pancreaticoduodenectomy for persistent symptoms. He had no perioperative morbidity and doing well in 24 months follow up.

GROOVE PANCREATITIS -A DIAGNOSTIC DILEMMA

2021 ◽  
pp. 55-56
Author(s):  
Aleena Elizabeth Andrews
Keyword(s):  
Surgical Intervention ◽  
Soft Tissue Mass ◽  
Pancreatic Head ◽  
Duodenal Wall ◽  
Diagnostic Dilemma ◽  
Tissue Mass ◽  
Groove Pancreatitis ◽  
Cystic Changes ◽  
The Common ◽  
Anatomical Area

Groove pancreatitis is a segmental chronic pancreatitis that affects the groove area, classically the anatomical area between the pancreatic head, the duodenum, and the common bile duct. The etiopathogenesis remains elusive till date, though association with alcohol abuse has been described in literature. Imaging feature described include soft tissue mass in the groove, thickening of medial wall of duodenum, thus closely mimicking a neoplastic aetiology and hence posing diagnostic dilemma. However classic ndings of cystic changes in the groove extending to duodenal wall and brotic component can aid the radiologist in making an accurate diagnosis and thus avoiding unnecessary surgical intervention. Groove pancreatitis is a disease that should be considered in the list of differential diagnosis of masses implicating the pancreatic head and medial duodenal wall.

RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH CHRONIC PANCREATITIS AND THE RISK OF CANCER AFTER SURGICAL TREATMENT

2018 ◽  
Vol 64 (2) ◽  
pp. 228-233
Author(s):  
Vladimir Lubyanskiy ◽  
Vasiliy Seroshtanov ◽  
Ye. Semenova
Keyword(s):  
Pancreatic Cancer ◽  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Fibrous Tissue ◽  
Pancreatic Head ◽  
Head Region ◽  
Intestinal Anastomoses ◽  
Resection Of The Pancreas ◽  
Risk Of Cancer

The aim: To analyze results of surgical treatment of patients with chronic pancreatitis (CP) and to assess the causes of pancreatic cancer after surgical treatment. Materials and methods: 137 patients had duodenum-preserving resections of the pancreas. Results: In the histological examination of the pancreas it was established that the growth of fibrous tissue was registered in patients with CP., which in 19 (13.8%) almost completely replaced the acinar tissue. In the long term after the operation from 6 months to 2 years in 8 patients (5.8%) pancreatic cancer was detected. Possible causes of tumor origin were analyzed, the value of preservation of ductal hypertension, which affects the state of the duct’s epithelium, was established. The most commonly used for treatment of chronic pancreatitis the Frey surgery removed pancreatic hypertension but in two patients during the operation an insufficient volume of the pancreatic head was reconstructed. In the case of the abandonment of a large array of fibrous tissue, local hypertension was retained in the region of the ductal structures of the head, which led to the transformation of the duct epithelium. An essential factor in the problem of the preservation of pancreatic hypertension were the stenosis of pancreatic intestinal anastomoses, they arose in the long term in 4 operated patients. With stenosis of anastomosis after duodenum-preserving resection both the hypertension factor and the regeneration factor could be realized, which under certain circumstances might be significant. Conclusion: After resection of the pancreas for CP cancer was diagnosed in 5.8% of patients. The main method of preventing the risk of cancer was performing the Frey surgery for CP eliminating pancreatic hypertension in the head region of the pancreas. Diagnosis of stenosis in the late period after resection of the pancreas was an important element in the prevention of recurrence of cancer since a timely reconstructive operation could improve the drainage of duct structures.

Adenocarcinoma of the Appendix in Elderly: Diagnostic dilemma

2020 ◽  
Vol 01 ◽  
Author(s):  
Heba Nofal ◽  
Hayder Al-Masari ◽  
Marwan Mohammed Rashed ◽  
Reham Ainawi ◽  
Desh Idnani ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Ct Scan ◽  
Laparoscopic Appendectomy ◽  
Signs And Symptoms ◽  
Morbidity And Mortality ◽  
Diagnostic Dilemma ◽  
Increased Risk

: Acute appendicitis in elderly continue to be a diagnostic dilemma as it raises both the suspicion of malignancy and increased risk of morbidity and mortality. Cancers of the appendix are rare and most of them are found accidentally on appendectomies performed for acute appendicitis. When reviewed, majority of the tumors were carcinoid, adenoma, and lymphoma. Adenocarcinomas of appendix are only 0.08% of all cancers and the treatment remains controversial. This paper presents a case of 75-year-old female presented to emergency (ER) with signs and symptoms mimicking acute appendicitis, laparoscopic appendectomy was planned after a CT scan was done as it was suggesting acute appendicitis. The specimen then was sent foe pathology lab and a diagnosis of adenocarcinoma of the appendix was made.

scholarly journals Pancreatic cancer Masquerading as lung nodules: A Diagnostic Dilemma

2021 ◽  
pp. 101453
Author(s):  
Rahul Karna ◽  
Anam Javed ◽  
Adeel Nasrullah ◽  
Atif Raja ◽  
Hammad Arshad
Keyword(s):  
Pancreatic Cancer ◽  
Lung Nodules ◽  
Diagnostic Dilemma

scholarly journals COVID-19 Impact on Medical Practice in Sub-Saharan Africa; The Need to Guard Against Medical Negligence: A Case Report in a Health Care Facility in Kumasi, Ghana

2021 ◽  
Vol 14 ◽  
pp. 2632010X2110253
Author(s):  
Paul Poku Sampene Ossei ◽  
William Gilbert Ayibor ◽  
John Taylor ◽  
Lawrence Agyemang ◽  
Kwabena Owusu Aninkora ◽  
...  
Keyword(s):  
Laboratory Tests ◽  
Respiratory Infections ◽  
Care Facility ◽  
Health Care Facility ◽  
Signs And Symptoms ◽  
Sub Saharan Africa ◽  
World Health ◽  
African Countries ◽  
Diagnostic Dilemma ◽  
Negative Results

With the novel coronavirus disease 2019 (COVID-19) still in pandemic mode, according to the World Health Organization (WHO), the African continent has experienced continued growth in the total tally. According to the Africa Centers for Disease Control and Prevention (CDC), the virus has spread to almost all 54 recognized African countries. Figures from the CDC indicate that the highly affected countries include South Africa, Egypt, Nigeria, Algeria, Morocco, and Ghana (with more than 55 000 cases and 400 deaths as of the time of writing). The WHO and the United Nations have projected the ongoing pandemic could push medical practitioners toward high rates of clinical misdiagnosis. So far, the coronavirus pandemic has been more devastating and life-threatening than the usual seasonal flu. As of the time of writing, here is presently no proven vaccine or treatment for the disease, with the vaccines still under development; hence, a timely and accurate diagnosis could prove critical. Patients can also receive supportive care earlier if they are diagnosed early. Considering the fact that the coronavirus infection mimics the signs and symptoms of normal flu and other respiratory infections, a problem now emerges, where these symptoms are treated as manifestations of the deadly virus. This has caused a diagnostic dilemma in the absence of laboratory tests with new cases adding to the pool daily. In Ghana, many patients on suspicion of flu-like symptoms are sometimes denied the care so deserved due to the stigma associated with the disease, often in cases where laboratory tests are absent. This study is a postmortem report of a client who died while on admission at a private medical facility. It was an unconfirmed case of COVID-19, and the client was left unattended to and died, having spent 8 days on the ward. His test report was not done initially, but the diagnosis was purely based on suspicion. Nasopharyngeal swabs conducted on the fifth day of admission proved negative. Results became available on the day of the client’s demise. Postmortem findings established the actual cause of death, and it was not COVID-19 related.

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