1.Endoscopic Ultrasound in the Diagnosis of Pancreatoduodenal Groove Pathology: Report of Three Cases and Brief Review of the Literature
Inés C ORÍA ; Juan E PIZZALA ; Augusto M VILLAVERDE ; Juan C SPINA ; Analía V PASQUA ; Julio C LAZARTE ; Oscar M MAZZA ; Mariano M MARCOLONGO
Clinical Endoscopy 2019;52(2):196-200
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.
Ampulla of Vater
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Bile Ducts
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Biopsy, Fine-Needle
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Cohort Studies
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Diagnosis
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Duodenum
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Head
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Humans
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Pancreatic Neoplasms
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Pathologic Processes
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Pathology
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Ultrasonography