Duodenojejunostomy treatment of groove pancreatitis-induced stenosis and obstruction of the horizontal duodenum:A case report  

作　　者：Yu Zhang Heng-Hui Cheng Wen-Juan Fan 

机构地区：[1]Department of Gastroenterology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei Province,China [2]Institution of Pathology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2023年第12期2945-2953,共9页世界胃肠外科杂志（英文版）（电子版）

基　　金：Supported by National Natural Science Foundation of China,No.82100568.

摘　　要：BACKGROUND Groove pancreatitis(GP)is a rare condition affecting the pancreatic groove region within the dorsal-cranial part of the pancreatic head,duodenum,and common bile duct.As a rare form of chronic pancreatitis,GP poses a diagnostic and therapeutic challenge for clinicians.GP is frequently misdiagnosed or not considered;thus,the diagnosis is often delayed by weeks or months.The treatment of GP is complicated and often requires surgical intervention,especially pancreatoduodenectomy.CASE SUMMARY A 66-year-old man with a history of long-term drinking was admitted to the gastroenterology department of our hospital,complaining of vomiting and acid reflux.Upper gastrointestinal endoscopy showed luminal stenosis in the descending part of the duodenum.Abdominal computed tomography showed slight exudation in the descending and horizontal parts of the duodenum with broadening of the groove region,indicating local pancreatitis.The symptoms of intestinal obstruction were not relieved with conservative therapy,and insertion of an enteral feeding tube was not successful.Exploratory laparoscopy was performed and revealed a hard mass with scarring in the horizontal part of the duodenum and stenosis.Intraoperative frozen section analysis showed no evidence of malignancy,and side-to-side duodenojejunostomy was performed.Routine pathologic examination showed massive proliferation of fibrous tissue,hyaline change,and the proliferation of spindle cells.Based on the radiologic and pathologic characteristics,a diagnosis of GP was made.The patient presented with anastomotic obstruction postoperatively and took a long time to recover,requiring supportive therapy.CONCLUSION GP often involves the descending and horizontal parts of the duodenum and causes duodenal stenosis,impaired duodenal motility,and gastric emptying due to fibrosis.

关 键 词：Groove pancreatitis Duodenal stenosis Duodenal obstruction DUODENOJEJUNOSTOMY Case report 

分 类 号：R656.6[医药卫生—外科学]