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Clinical and Morphological Features of Paraduodenal Pancreatitis: An Italian Experience With 120 Patients

de Pretis, Nicolò MD; Capuano, Fabiana MD; Amodio, Antonio MD, PhD; Pellicciari, Mattia MD; Casetti, Luca MD; Manfredi, Riccardo MD, PhD; Zamboni, Giuseppe MD, PhD; Capelli, Paola MD; Negrelli, Riccardo MD; Campagnola, Pietro MD; Fuini, Arnaldo MD; Gabbrielli, Armando MD; Bassi, Claudio MD; Frulloni, Luca MD, PhD

doi: 10.1097/MPA.0000000000000781
Original Articles
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Objectives This study aimed to evaluate the clinical and radiological features and clinical outcomes of paraduodenal pancreatitis (PP).

Methods A final diagnosis of PP was based on surgical specimens in resected patients and on imaging in nonoperated patients. Clinical, radiological, and pathological data were collected and reevaluated.

Results We studied 120 patients, 97.5% of whom were drinkers and 97.5% were smokers. Symptoms at clinical onset were acute pancreatitis in 78 patients (65%) and continuous pain in 68 patients (55.8%). Other symptoms were vomiting (36.7%), weight loss (25.8%), and jaundice (11.7%). Cystic variant was diagnosed in 82 patients (68.0%), and solid variant was diagnosed in 38 patients (32.0%). Pure and diffuse forms were observed in 22 (18.3%) and 98 (81.7%) patients, respectively. Pancreatic calcifications were present at clinical onset in 5.0% of the patients and in 61.0% at the end of follow-up. Somatostatin analogs were used in 13 patients (10.8%), and 81 patients (67.0%) underwent surgery.

Conclusions The clinical profile of PP was found to be middle-aged men who were heavy drinkers and smokers with painful pancreatitis and was associated with vomiting and weight loss. In nonresponders, alcohol withdrawal and medical therapy can be proposed as a first-line treatment, and surgery as a second-line treatment.

From the Departments of *Medicine, †Surgery, ‡Radiology, and §Pathology, Pancreas Center, University of Verona; and ∥Gastroenterology Unit, Ospedale Maggiore, Verona, Italy.

Received for publication April 13, 2016; accepted October 17, 2016.

Address correspondence to: Luca Frulloni, MD, PhD, Department of Medicine, Pancreas Center, University of Verona, Policlinico GB Rossi, p.le LA Scuro, 10, 37134 Verona, Italy (e-mail: luca.frulloni@univr.it).

The authors declare no conflict of interest.

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