Abstract
BACKGROUND: Groove pancreatitis (GP) is a rare focal chronic pancreatitis of the pancreaticoduodenal groove that is usually diagnosed in chronic alcoholics. However, it is often difficult to differentiate from pancreatic or periampullary cancers. In this study, we report a case of GP with the rare symptom of severe gastric outlet obstruction. CASE SUMMARY: A 68-year-old man presented to our institution with severe gastric outlet obstruction accompanied by vomiting persisted for 3 days, severe electrolyte imbalance, and altered mental status with cardiac arrest. Differential diagnosis of cancers of the ampulla of Vater or duodenum was difficult due to discordant findings from preoperative imaging and an endoscopic biopsy of the lesion. In addition, the gastric outlet obstruction did not improve with conservative treatment; therefore, pancreatoduodenectomy was performed. Postoperatively, the histological findings revealed multiple cystic lesions in the duodenal wall that were collectively diagnosed as GP. The patient underwent a follow-up 3 years postoperatively and was found to have no postoperative sequelae. CONCLUSION: In this case of GP, pancreatoduodenectomy safely treated severe gastric outlet obstruction when a cancer diagnosis could not be excluded.