Groove pancreatitis, a form of chronic pancreatitis affecting the head of the pancreas, is localized within the groove between the pancreas head, duodenum, and common bile duct. We report a case of a male patient with groove pancreatitis who initially underwent a duodenal preserving gastrenteranastomosis. Unfortunately, the patient's symptoms were only partially controlled, necessitating a pancreaticoduodenectomy in due course as the definite surgical restoration procedure. The surgical approach selected proved inadequate since the patient's symptoms did not resolve over time. This reflects that by-pass operations like these are not indicated for the management of patients with groove pancreatitis.
An unusual case of an extensive collateral circulation through a dilated superficial abdominal vein was found from the left femoral vein to the left axillary vein in a 23-year-old man (Picture 1). His medical history included a post-natal thrombosis of the left common femoral vein during a central venous catheterization procedure. Magnetic resonance imaging (MRI) of the abdomen with gadolinium contrast enhancement examination was performed (1). An aplasia of both iliac veins and inferior vena cava was diagnosed (Picture 2) (2). Blood return from the lower extremities was seen through an enlarged subcutaneous abdominal wall vein [(white arrows) Picture 3a, b, 4] on the left side and en-
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