© Science and Education Publishing DOI:10.12691/ajmcr-2-12-10 Groove Pancreatitis or Pancreatic Neoplasm: A Surgical Dilemmas

Abstract Background: Groove pancreatitis (GP) is a rare condition characterized by inflammatory fibrosis of the space between the dorsal-cranial part of the head of the pancreas, duodenum and common bile duct. Surgery is often the choice of treatment. Case report: A 44-year-old male patient with a history of a high alcoholic intake came with epigastric pain associated with a weight loss. An abdominal ultrasonography, a computer tomography (CT) and a gastro-duodenoscopy showed a mass of the pancreatic head with duodenal infiltration suggesting for adenocarcinoma of the pancreas. An endoscopic ultrasound- fine needle aspiration (EUS-FNA) did not show any sign of chronic inflammation. The patient underwent Whipple procedure. Histologic examination confirmed chronic inflammation in the groove area with a ruptured pancreatic-type cyst and some pseudocysts in depth of the wall. Conclusion: The diagnosis of GP is challenging. Radiological and endoscopic findings and symptoms are often not specific and they could also be present in patients with adenocarcinoma of the pancreas. The pancreaticoduodenectomy is often the choice of treatment when symptoms do not improve or when there is uncertainty over the diagnosis