Groove pancreatitis is a rare form of chronic pancreatitis, affecting the area between the duodenum, common bile duct and pancreatic head. The pathophysiology of groove pancreatitis is unclear, and several mechanisms have been proposed. This disease can mimic duodenal, pancreatic or periampular neoplasms. We present a series of 4 patients diagnosed of groove pancreatitis at a tertiary medical center over a 3-year period. Three of the patients were surgically treated, recovering weight and removing pain. The other one was treated with medical treatment. Same results were observed. Brief review of the literature was performed. Groove pancreatitis (GP) is usually a segmental chronic pancreatitis, characterized by fibrotic inflammation of the “groove” between the head of the pancreas, duodenum and common bile duct.  It is considered to be infrequent maybe due to an under diagnosis. The real prevalence is unknown and some studies report a prevalence as high as 24.5% in pancreaticoduodenectomy specimens from patients with chronic pancreatitis. GP has received different names in the literature including paraduodenal wall cyst, pancreatic hamartoma of the duodenum, cystic dystrophy of heterotopic pancreas and myoadenomatosis. The different terms used to describe this clinical entity makes it difficult to have accurate bibliographic information. GP occurs mainly in alcoholicand/or smoking men in the fifth decade of life. The predominant symptoms in these patients are upper abdominal pain and recurrent vomiting mainly due to duodenal stenosis often leading to significant weight loss. Sometimes there is jaundice too. Imaging typically reveals duodenal stenosis and cystic lesion(s) near the head of the pancreas. This condition can often be difficult to differentiate from pancreatic head adenocarcinoma but certain clinical, radiological and histological features can be useful in making a diagnosis. When the diagnosis is clear, GP can be treated by conservative medical measures, including endoscopic therapy as the first line of intervention. [6] However, surgery is often required when clinical symptoms are severe and not responding to medical or conservative treatment as well as to rule out malignancy. We provide a summary of 4 patient diagnosed of groove pancreatitis.

With Regards,
Sara Giselle
Associate Managing Editor
Global  Journal of Digestive Diseases