Xanthogranulomatous pancreatitis treated by duodenum-preserving pancreatic head resection

Hepatobiliary Pancreat Dis Int. 2010 Apr;9(2):216-8.

Abstract

Background: Xanthogranulomatosis is an idiopathic, rare process in which lipid-laden histiocytes are deposited at various locations in the body. We present two cases who were treated by duodenum-preserving pancreatic head resection and eventually diagnosed as having xanthogranulomatous pancreatitis.

Methods: A 30-year-old caucasian man was admitted to our clinic for vague abdominal pain and epigastric dullness. Magnetic resonance cholangiopancreatography and endoscopic retrograde pancreatography suggested the existence of chronic pancreatitis. Another 34-year-old caucasian woman was admitted to our clinic because of right upper quadrant pain. Magnetic resonance cholangiopancreatography demonstrated a dilatation and stone of the main pancreatic duct. Based on a diagnosis of chronic pancreatitis, pancreatic head resection was planned and a laparotomy was performed in both of cases.

Results: In both cases, duodenum-preserving pancreatic head resection was performed. Macroscopic and microscopic findings revealed xanthogranulomatous inflammation, which led to a diagnosis of xanthogranulomatous pancreatitis.

Conclusion: Although this type of pancreatitis is extremely rare, it is important to keep it in mind for a differential diagnosis because it may simulate chronic pancreatitis or a malignant tumor on imaging.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Duodenum / surgery*
  • Female
  • Granuloma / pathology
  • Granuloma / surgery*
  • Humans
  • Male
  • Pancreas / surgery*
  • Pancreatitis / pathology
  • Pancreatitis / surgery*
  • Xanthomatosis / pathology
  • Xanthomatosis / surgery*