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.

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.