Pezzilli R, Santini D, Calculli L, Casadei R, Morselli-Labate AM, Imbrogno A, Fabbri D, Taffurelli G, Ricci C, Corinaldesi R. Cystic dystrophy of the duodenal wall is not always associated with chronic pancreatitis. World J Gastroenterol 2011; 17(39): 4349-4364 [PMID: 22110260 DOI: 10.3748/wjg.v17.i39.4349]
Corresponding Author of This Article
Dr. Raffaele Pezzilli, Pancreas Unit, Department of Digestive Diseases and Internal Medicine, Sant’Orsola-Malpighi Hospital, 40138 Bologna, Italy. raffaele.pezzilli@aosp.bo.it
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Editorial
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World J Gastroenterol. Oct 21, 2011; 17(39): 4349-4364 Published online Oct 21, 2011. doi: 10.3748/wjg.v17.i39.4349
Cystic dystrophy of the duodenal wall is not always associated with chronic pancreatitis
Raffaele Pezzilli, Donatella Santini, Lucia Calculli, Riccardo Casadei, Antonio Maria Morselli-Labate, Andrea Imbrogno, Dario Fabbri, Giovanni Taffurelli, Claudio Ricci, Roberto Corinaldesi
Raffaele Pezzilli, Antonio Maria Morselli-Labate, Andrea Imbrogno, Dario Fabbri, Roberto Corinaldesi, Pancreas Unit, Department of Digestive Diseases and Internal Medicine, Sant’Orsola-Malpighi Hospital, 40138 Bologna, Italy
Donatella Santini, Department of Pathology, Sant’Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy
Lucia Calculli, Department of Radiology, Sant’Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy
Riccardo Casadei, Giovanni Taffurelli, Claudio Ricci, Department of Surgery, Sant’Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy
Author contributions: Pezzilli R, Santini D, Calculli L, Casadei R, Taffurelli G and Ricci C followed the patients clinically; Imbrogno A, Fabbri D and Morselli-Labate AM collected the literature data; Morselli-Labate AM and Pezzilli R analyzed the data and interpreted the results; Pezzilli R and Corinaldesi R co-ordinated and collected all the patient information; Pezzilli R designed the study and wrote the manuscript.
Correspondence to: Dr. Raffaele Pezzilli, Pancreas Unit, Department of Digestive Diseases and Internal Medicine, Sant’Orsola-Malpighi Hospital, 40138 Bologna, Italy. raffaele.pezzilli@aosp.bo.it
Telephone: +39-051-6364148 Fax: +39-051-6364148
Received: February 18, 2011 Revised: March 31, 2011 Accepted: April 7, 2011 Published online: October 21, 2011
Abstract
Cystic dystrophy of the duodenal wall is a rare form of the disease which was described in 1970 by French authors who reported the presence of focal pancreatic disease localized in an area comprising the C-loop of the duodenum and the head of the pancreas. German authors have defined this area as a “groove”. We report our recent experience on cystic dystrophy of the paraduodenal space and systematically review the data in the literature regarding the alterations of this space. A MEDLINE search of papers published between 1966 and 2010 was carried out and 59 papers were considered for the present study; there were 19 cohort studies and 40 case reports. The majority of patients having groove pancreatitis were middle aged. Mean age was significantly higher in patients having groove carcinoma. The diagnosis of cystic dystrophy of the duodenal wall can now be assessed by multidetector computer tomography, magnetic resonance imaging and endoscopic ultrasonography. These latter two techniques may also add more information on the involvement of the remaining pancreatic gland not involved by the duodenal malformation and they may help in differentiating “groove pancreatitis” from “groove adenocarcinoma”. In conclusion, chronic pancreatitis involving the entire pancreatic gland was present in half of the patients with cystic dystrophy of the duodenal wall and, in the majority of them, the pancreatitis had calcifications.
