Dushyant S Dahiya, Yash R Shah, Andrew Canakis, Charmy Parikh, Saurabh Chandan, Hassam Ali, Manesh K Gangwani, Bhanu S M Pinnam, Sahib Singh, Amir H Sohail, Raj Patel, Daryl Ramai, Mohammad Al-Haddad, Todd Baron, Amit Rastogi
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引用次数: 0
摘要
沟状胰腺炎(GP)是一种罕见的、临床上独特的慢性胰腺炎,影响胰十二指肠沟,包括胰头、十二指肠和胆总管。该病多发于 4-5 十岁的人群,男性患者多于女性。过量饮酒、吸烟、胰管结石、胰腺分隔、环状胰腺、异位胰腺、十二指肠壁增厚和消化性溃疡是导致 GP 的重要危险因素。通常出现的症状包括剧烈腹痛、恶心、呕吐、腹泻、体重减轻和黄疸。由于 GP 与影响同一解剖位置的多种良性和恶性疾病在临床和放射学上存在明显重叠,因此确诊 GP 通常具有挑战性。这可能会导致延误开始治疗,从而增加发病率、死亡率和并发症发生率。近年来,人工智能(AI)的研究前景广阔,引起了人们的极大兴趣。由于人工智能在影像诊断中的广泛应用以及其高度的灵敏性和特异性,人工智能有可能成为区分 GP 和胰腺恶性肿瘤的重要工具,从而防止漏诊或延误诊断。在本文中,我们将对 GP 进行全面综述,内容包括病因、发病机制、临床表现、放射学和内镜评估、管理策略和未来发展方向。本文还旨在提高临床医生对这种鲜为人知且经常被误诊的临床实体的认识,最终改善患者的预后。
Groove pancreatitis: From enigma to future directions-A comprehensive review.
Groove pancreatitis (GP) is a rare and clinically distinct form of chronic pancreatitis affecting the pancreaticoduodenal groove comprising the head of the pancreas, duodenum, and the common bile duct. It is more prevalent in individuals in their 4-5th decade of life and disproportionately affects men compared with women. Excessive alcohol consumption, tobacco smoking, pancreatic ductal stones, pancreatic divisum, annular pancreas, ectopic pancreas, duodenal wall thickening, and peptic ulcers are significant risk factors implicated in the development of GP. The usual presenting symptoms include severe abdominal pain, nausea, vomiting, diarrhea, weight loss, and jaundice. Establishing a diagnosis of GP is often challenging due to significant clinical and radiological overlap with numerous benign and malignant conditions affecting the same anatomical location. This can lead to a delay in initiation of treatment leading to increasing morbidity, mortality, and complication rates. Promising research in artificial intelligence (AI) has garnered immense interest in recent years. Due to its widespread application in diagnostic imaging with a high degree of sensitivity and specificity, AI has the potential of becoming a vital tool in differentiating GP from pancreatic malignancies, thereby preventing a missed or delayed diagnosis. In this article, we provide a comprehensive review of GP, covering the etiology, pathogenesis, clinical presentation, radiological and endoscopic evaluation, management strategies, and future directions. This article also aims to increase awareness about this lesser known and often-misdiagnosed clinical entity amongst clinicians to ultimately improve patient outcomes.
期刊介绍:
Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.