title: Clinical and Morphological Features of Paraduodenal Pancreatitis: An Italian Experience With 120 Patients.
abstract: This study aimed to evaluate the clinical and radiological features and clinical outcomes of paraduodenal pancreatitis (PP).
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: From the Departments of *Medicine, †Surgery, ‡Radiology, and §Pathology, Pancreas Center, University of Verona; and ∥Gastroenterology Unit, Ospedale Maggiore, Verona, Italy.
authors.forename: Nicolò
authors.initials: N
authors.lastname: de Pretis
authors.forename: Fabiana
authors.initials: F
authors.lastname: Capuano
authors.forename: Antonio
authors.initials: A
authors.lastname: Amodio
authors.forename: Mattia
authors.initials: M
authors.lastname: Pellicciari
authors.forename: Luca
authors.initials: L
authors.lastname: Casetti
authors.forename: Riccardo
authors.initials: R
authors.lastname: Manfredi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Zamboni
authors.forename: Paola
authors.initials: P
authors.lastname: Capelli
authors.forename: Riccardo
authors.initials: R
authors.lastname: Negrelli
authors.forename: Pietro
authors.initials: P
authors.lastname: Campagnola
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Fuini
authors.forename: Armando
authors.initials: A
authors.lastname: Gabbrielli
authors.forename: Claudio
authors.initials: C
authors.lastname: Bassi
authors.forename: Luca
authors.initials: L
authors.lastname: Frulloni
mesh_terms: D000208:Acute Disease; D000328:Adult; D000428:Alcohol Drinking; D003952:Diagnostic Imaging / Q000379:methods*; D004386:Duodenum / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010180:Pancreatectomy; D010195:Pancreatitis / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000628:therapy; D012907:Smoking; D013004:Somatostatin / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D013004:Somatostatin