Segmental Pancreatitis Research Paper

Groove/paraduodenal pancreatitis: Groove or paraduodenal pancreatitis is a rare type of focal chronic pancreatitis; which can affect the groove between the head of the pancreas, the duodenum, and the common bile duct. The rest of the pancreatic parenchyma is slightly compromised or spared (Blasbalg et al, 2007). Groove pancreatitis is categorized into two forms: pure, involving exclusively the groove; or segmental (Figure 47), involving the groove and extending in to the pancreatic head. Both pure and segmental form can cause progressive stenosis of the pancreatic duct, subsequently leading to diffuse chronic pancreatitis (Blasbalg et al, 2007). The most characteristic finding on MRI is a sheet like mass between the duodenal C-loop and
head of pancreas. The mass shows low signal on T1-weighted images compared to the rest of the pancreatic parenchyma, and variable signal on T2-weighted images. This variation in the T2 signal can be referred to the time of onset of the disease; as sub acute form of the disease demonstrates brighter signal on T2-weighted images due to edema, while chronic form of the disease has a lower T2 signal due to fibrosis (Raman et al, 2013). Post gadolinium-enhanced dynamic images show delayed and progressive heterogeneous enhancement, indicating the fibrous nature of the tissue. Cystic lesions can be also well seen on T2-weighted images in the groove or duodenal wall (Manikkavasakar et al,2014).