Kim N, Lee H, Park D. Challenging diagnosis of groove pancreatitis with severe gastric outlet obstruction: A case report. World J Clin Cases 2025; 13(32): 111796 [DOI: 10.12998/wjcc.v13.i32.111796]
Corresponding Author of This Article
Huisong Lee, MD, PhD, Associate Professor, Department of Surgery, Ewha Womans University College of Medicine, No. 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, South Korea. huisong.lee@ewha.ac.kr
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Surgery
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Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 16, 2025 (publication date) through Nov 15, 2025
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World Journal of Clinical Cases
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Kim N, Lee H, Park D. Challenging diagnosis of groove pancreatitis with severe gastric outlet obstruction: A case report. World J Clin Cases 2025; 13(32): 111796 [DOI: 10.12998/wjcc.v13.i32.111796]
World J Clin Cases. Nov 16, 2025; 13(32): 111796 Published online Nov 16, 2025. doi: 10.12998/wjcc.v13.i32.111796
Challenging diagnosis of groove pancreatitis with severe gastric outlet obstruction: A case report
Naru Kim, Huisong Lee, DaeJoon Park
Naru Kim, Huisong Lee, DaeJoon Park, Department of Surgery, Ewha Womans University College of Medicine, Seoul 07985, South Korea
Author contributions: Kim N contributed to manuscript writing; Park D contributed to editing; Lee H contributed to conceptualization and supervision. All authors approved final revision of the paper.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Huisong Lee, MD, PhD, Associate Professor, Department of Surgery, Ewha Womans University College of Medicine, No. 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, South Korea. huisong.lee@ewha.ac.kr
Received: July 10, 2025 Revised: August 14, 2025 Accepted: September 30, 2025 Published online: November 16, 2025 Processing time: 126 Days and 4.5 Hours
Abstract
BACKGROUND
Groove pancreatitis (GP) is a rare focal chronic pancreatitis of the pancreaticoduodenal groove that is usually diagnosed in chronic alcoholics. However, it is often difficult to differentiate from pancreatic or periampullary cancers. In this study, we report a case of GP with the rare symptom of severe gastric outlet obstruction.
CASE SUMMARY
A 68-year-old man presented to our institution with severe gastric outlet obstruction accompanied by vomiting persisted for 3 days, severe electrolyte imbalance, and altered mental status with cardiac arrest. Differential diagnosis of cancers of the ampulla of Vater or duodenum was difficult due to discordant findings from preoperative imaging and an endoscopic biopsy of the lesion. In addition, the gastric outlet obstruction did not improve with conservative treatment; therefore, pancreatoduodenectomy was performed. Postoperatively, the histological findings revealed multiple cystic lesions in the duodenal wall that were collectively diagnosed as GP. The patient underwent a follow-up 3 years postoperatively and was found to have no postoperative sequelae.
CONCLUSION
In this case of GP, pancreatoduodenectomy safely treated severe gastric outlet obstruction when a cancer diagnosis could not be excluded.
Core Tip: Groove pancreatitis is a rare form of chronic pancreatitis, but cases continue to be reported. Total gastric outlet obstruction, as in our case, is extremely uncommon. The anatomical complexity of the groove area makes accurate diagnosis challenging, especially when a mass involves the pancreas, duodenum, or biliary tract. Treatment options range from conservative care to surgery, and accurate differentiation from malignancy is critical. However, discordant findings across imaging, laboratory findings, and biopsy results often hinder decision-making. In select cases, aggressive surgical intervention may provide definitive diagnosis, shorten treatment duration, and reduce recurrence, as demonstrated in our patient.
