單純型溝糟狀胰臟炎

Pure-Form Groove Pancreatitis

Groove pancreatitis (GP) is an uncommon form of chronic pancreatitis. It is classified into two forms of groove pancreatitis, the ＂segmental＂ and the ＂pure＂. The former involves the pancreatic head with development of scar tissue within the groove, while the latter affects only the groove itself, sparing the pancreatic head. Most patients are middle-aged men, typically with history of heavy alcohol drinking and/or tabacco smoking. The pathogenesis is unclear. Most patients present with severe abdominal pain, recurrent vomiting and weight loss. Jaundice is relatively rare. Paraduodenal cyst is very common in GP and it is present within the duodenal wall or in the groove area. It originates from cystic dystrophy of ectopic pancreatic tissue. CT and MRI/MRCP are useful in the diagnosis of GP. Blood biochemistry tests often reveal mildly elevated or normal pancreatic enzymes and tumor markers are usually normal. We presented a case of 45 year-old alcoholic male patient. He complained of upper abdominal pain for four months. Serum biochemistry examination revealed normal serum amylase level, serum lipase level and normal liver function. The CEA and CA19-9 were also within normal limit. Abdominal ultrasound revealed unremarkable change. CT and MRI/MRCP reveled typical changes of GP. Needle aspiration of duodenal submucosal cyst revealed marked elevation of lipase and amylase (Lipase 107200 U, Amylase 31980 U). The bile duct and pancreatic duct were normal in MRCP and ERCP.