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Paraduodenal pancreatitis: benign and malignant mimics at MRI

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Abstract

Paraduodenal pancreatitis, also known as groove pancreatitis, is a rare form of chronic pancreatitis that masquerades as pancreatic adenocarcinoma affecting the pancreaticoduodenal groove, a potential space between the head of the pancreas, duodenum, and common bile duct. Two forms of groove pancreatitis have been described. The segmental form involves the pancreatic head with development of scar tissue within the groove, whereas the pure form affects the groove only, sparing the pancreatic head. Imaging findings of groove pancreatitis often overlap with primary duodenal, ampullary, or pancreatic neoplasms, which often results in a diagnostic challenge. In addition, paraduodenal pancreatitis can be mistaken for cystic pancreatic lesions, especially when there is involvement of the duodenal wall. Preoperative recognition of this entity is very important in order to avoid unnecessary procedures, although surgery, such as pancreaticoduodenectomy, may still be required to relieve obstructive symptoms. In this article, the pathophysiology and magnetic resonance imaging characteristics of paraduodenal pancreatitis and important benign and malignant mimics are discussed.

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Acknowledgements

The authors would like to express special thanks to Ms Nadezda Krasnoperova-Brown, Senior Graphic Designer, Communication and Creative Services, Department of Radiology and Imaging Sciences, Emory University School of Medicine, for drawing Fig. 1.

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Authors and Affiliations

  1. Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1365 Clifton Road NE, Building A, Suite AT-627, Atlanta, GA, 30322, USA

    Pardeep K. Mittal, Peter Harri, Sadhna Nandwana, Courtney C. Moreno, Kelly Cox & Lauren F. Alexander

  2. Department of Pathology, Emory University School of Medicine, Atlanta, GA, USA

    Takashi Muraki, Volkan Adsay & Burcin Pehlivanoglu

  3. Department of Radiology Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Argha Chatterjee & Frank H. Miller

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  1. Pardeep K. Mittal
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Correspondence to Pardeep K. Mittal.

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Mittal, P.K., Harri, P., Nandwana, S. et al. Paraduodenal pancreatitis: benign and malignant mimics at MRI. Abdom Radiol 42, 2652–2674 (2017). https://doi.org/10.1007/s00261-017-1238-9

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