Constitutional Syndrome, Ascites and Duodenal Thickening Presenting as Groove Pancreatitis

Groove pancreatitis (GP) is a very infrequent subtype of chronic pancreatitis affecting the pancreatic-duodenal junction. It usually manifests in middle-aged men with a history of chronic alcoholism, though it has also been described in women and in individuals who do not consume alcohol([1]). Even though the underlying etiology is unclear, chronic alcohol consumption is known to increase the viscosity of the pancreatic juice and exacerbate the inflammatory process([2]). We present a case of GP that posed diagnostic difficulties because it manifested as ascites and duodenal thickening, with pancreatic imaging findings initially normal. LEARNING POINTS: Groove pancreatitis typically manifests as upper hemiabdominal pain, postprandial vomiting and weight loss. It is important to establish a differential diagnosis with carcinoma of the head of the pancreas and duodenal neoplasms. Presentation of the disease in the form of ascites is exceptional but a possibility that must be taken into account.