Endoscopic Ultrasound in the Diagnosis of Pancreatoduodenal Groove Pathology: Report of Three Cases and Brief Review of the Literature

The pancreatoduodenal groove is a small area where pathologic processes involving the distal bile duct, duodenum, pancreatic head, ampulla of Vater, and retroperitoneum converge. Despite great advances in imaging techniques, a definitive preoperative diagnosis is challenging because of the complex a...

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Bibliographic Details
Main Authors: Inés C. Oría, Juan E. Pizzala, Augusto M. Villaverde, Juan C. Spina, Analía V. Pasqua, Julio C. Lazarte, Oscar M. Mazza, Mariano M. Marcolongo
Format: Article
Language:English
Published: Korean Society of Gastrointestinal Endoscopy 2019-03-01
Series:Clinical Endoscopy
Subjects:
Online Access:http://www.e-ce.org/upload/pdf/ce-2018-097.pdf
Description
Summary:The pancreatoduodenal groove is a small area where pathologic processes involving the distal bile duct, duodenum, pancreatic head, ampulla of Vater, and retroperitoneum converge. Despite great advances in imaging techniques, a definitive preoperative diagnosis is challenging because of the complex anatomy of this area. Therefore, surgical intervention is frequently required because of the inability to completely exclude malignancy. We report 3 cases of patients with different groove pathologies but similar clinical and imaging presentation, and show the essential role of endoscopic ultrasound (EUS) in making a specific preoperative diagnosis, excluding malignancy in the first case, changing diagnosis in the second case, and confirming malignancy in the third case. EUS was a fundamental tool in this cohort of patients, not only because of its ability to provide superior visualization of a difficult anatomical region, but because of the ability to guide precise, real-time procedures, such as fine-needle aspiration.
ISSN:2234-2400
2234-2443