Eosinophilic pancreatitis mimicking pancreatic neoplasia

Department of Pediatric Surgery, Karadeniz Technical University, Trabzon, Turkey.
Canadian journal of gastroenterology = Journal canadien de gastroenterologie (Impact Factor: 1.98). 06/2006; 20(5):361-4.
Source: PubMed


Eosinophilic pancreatitis (EP) is a rare disease. It typically occurs in the setting of either eosinophilic gastroenteritis or the hypereosinophilic syndrome. Isolated eosinophilic infiltration of the pancreas is less common. EP usually presents as a pancreatic tumour with abdominal pain and/or obstructive jaundice. The diagnosis is often not made until after pancreatic resection under suspicion of a pancreatic tumour. The case of a 14-year-old boy whose initial presentation was suggestive of a pancreatic tumour is reported. Radiological evaluation revealed a pancreatic mass suggestive of a pancreatic tumour obstructing the duodenum and common bile duct. The patient underwent surgery and a gastrojejunal anostomosis, tube cholecystostomy and biopsy were performed with no postoperative complications. The diagnosis of EP was established after surgical biopsy. The biopsy specimen revealed prominent eosinophilic infiltration. Serum immunoglobulin E levels were elevated. The patient was treated with oral prednisolone (40 mg/day). After two months of oral steroid therapy, clinical manifestations rapidly improved and peripheral eosinophilia subsided. Computed tomography scan revealed remission of the pancreatic mass-like lesion.

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    • "Its association with either EG or IHS is in itself a diagnostic challenge since patients have symptoms and signs due to these rare conditions [13]. Parasitic infestation, pancreatic carcinoma, acute/chronic pancreatitis, carcinoma of the duodenum, peptic ulcer disease, regional enteritis, post-surgical stricture and gallstone disease must all be included in the differential diagnosis [7] [19]. "

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