Paraduodenal pancreatitis

Case contributed by Dr Domenico Nicoletti

Presentation

Epigastric pain and vomiting with an increase of the lipase in alcoholic.

Patient Data

Age: 45 years
Gender: Male
CT

The walls of the second part of the duodenum are thickened with a small volume of free fluid; there are recognizable ectopic pancreatic islands with a similar degree of enhancement to the rest of the pancreas. The adjacent fat tissue is hyperdense due to inflammation. There are multiple foci of calcification in the pancreas. Normal biliary tree.

Case Discussion

Paraduodenal pancreatitis is characterized by a history of excess alcohol and tobacco use in male patients, and a painful symptomatology. Histology analysis demonstrates granulomatous tissue, stromal proliferation, and ectopic pancreatic tissue within the duodenal wall. The epicentre of the inflammation is typically located between the duodenum, common bile duct and pancreas. The presence of cysts inside the inflamed duodenal wall allows distinguishing between a "cystic" (75%) and a "solid" variant of paraduodenal pancreatitis.

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Case information

rID: 55358
Case created: 31st Aug 2017
Last edited: 10th Sep 2017
Inclusion in quiz mode: Included

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