Paraduodenal (groove) pancreatitis: case report
https://doi.org/10.23946/2500-0764-2026-11-1-58-64
Abstract
Aim. To present a clinical observation of paraduodenal pancreatitis with an analysis of differential diagnosis, patient management features, and justification of treatment tactics.
Materials and methods. A clinical case of a 48-year-old man with recurrent epigastric pain syndrome over a period of five years was analyzed. The study used general clinical and laboratory methods (including the examination of cancer markers and pancreatic elastase-1), methods of radiological and endoscopic diagnostics (endoscopic ultrasound, computed tomography and magnetic resonance imaging, fibrogastroduodenoscopy), histological examination of surgical material, and dynamic observation over a period of 5 years. The patient provided written voluntary informed consent for the publication of the data.
Results. The patient was diagnosed with segmental cystic para-duodenal pancreatitis with thickening of the medial wall of the duodenum, cystic inclusions, and narrowing of the duodenal lumen. The normal level of cancer markers, the results of the histological examination (chronic pancreatitis with fibrosis), and the stability of the process during dynamic observation allowed for the exclusion of adenocarcinoma. An organ-preserving surgery (resection of the pancreatic head with pancreatojejunostomy) was performed, and subsequent conservative therapy proved to be effective without the development of exocrine insufficiency.
Conclusion. Paraduodenal pancreatitis remains a diagnostic challenge due to its rarity and similarity to pancreatic head tumors. The key elements of diagnosis verification include the integration of imaging techniques, the level cancer markers, and morphological studies. Organ-preserving surgical interventions, combined with conservative therapy, can be an effective alternative to pancreatoduodenectomy in cases where the process is confirmed to be benign. Given the lack of standardized protocols for managing patients with this type of pancreatitis, treatment decisions should be made on a case-by-case basis.
About the Authors
M. S. Karyagina
Kemerovo State Medical University
Russian Federation
Russian Federation
Dr. Maria S. Karyagina, MD, Cand. Sci (Medicine), Associate Professor of the Department of Hospital Therapy and Clinical Pharmacology
Voroshilova Street, 22A, Kemerovo, 650056
S. A. Smakotina
Kemerovo State Medical University
Russian Federation
Russian Federation
Dr. Svetlana A. Smakotina, MD, Dr.Sci/ (Medicine), Associate Professor, Head of the Department of Hospital Therapy and Clinical Pharmacology
Voroshilova Street, 22A, Kemerovo, 650056
M. A. Klimova
Kuzbass Clinical Hospital of Emergency Medical Care named after M.A. Podgorbunsky
Russian Federation
Russian Federation
Dr. Marina A. Klimova, MD, Head of the X-ray Department No. 1
N. Ostrovsky Street, 22, Kemerovo, 650099
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Review
For citations:
Karyagina M.S., Smakotina S.A., Klimova M.A. Paraduodenal (groove) pancreatitis: case report. Fundamental and Clinical Medicine. 2026;11(1):58-64. (In Russ.) https://doi.org/10.23946/2500-0764-2026-11-1-58-64
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