Abstract
A 39-year-old man was admitted to the hospital because of a sudden epigastralgia. He had been drinking sake of about 200ml per day for 20 years, and diagnosed as pancreatitis 5 years before. Extensive examinations revealed: stenosis of the duodenum, many pancreatic stones in the Santorini's duct, tubular narrowing of the common bile duct, and the pancreatic pseudocyst connecting with the main pancreatic duct. Judging from those findings, we planned to perform cystduodenostomy under the diagnosis of recrudescence of chronic pancreatitis with pseudocyst. Upon laparotomy, however, the pancreatic body and tail were almost normal and marked hyperplasia of the Brunner's glands was confirmed, which indicated groove pancreatitis. Therefore, a pancreatoduodenectomy was performed. During the operation changes in the shape of the cyst and an active ulcer in the duodenal bulb were also observed.
It is said that groove pancreatitis is caused by obstruction of the pancreatic juice out flow due to occlusion of the Santorini's duct. Thus, we can guess that the disease presents various clinical courses. In this case, hard drinking and the stones in the Santorini's duct might allow to cause the disease.
