Groove pancreatitis: A Pancreatic Dilemmoma

Pancreatic inflammation limited to the area between the wall of the duodenum and common bile duct is referred to as groove pancreatitis. The condition is often associated with cystic dystrophy in the medial wall of the duodenum. These patients can present with features of either pancreatitis or pancreatic malignancy. CA19.9 levels are usually normal and serum amylase and lipase may be slightly elevated. Diagnosis is confirmed with either computerized tomography abdomen or endoscopic ultrasound. Management consists of conservative management and endoscopic shincterotomy. Pancreatico-duodenectomy may be required in some cases. In our case, a pancreatico-duodenectomy was required as the patient was suffering from gastric outlet obstruction and severe episodes of recurrent acute pancreatitis.