Discussion:

Groove pancreatitis is a rare type of chronic pancreatitis, primarily affecting the head of the pancreas. This lesion is classically described in middle-aged men and pathonomic for chronic alcohol use. The clinician should be alerted if seen as the patient may not divulge history alcohol use/abuse which may un-expectantly lead to delirium tremors. It can also be seen in smokers and women, but to a lesser degree. It can present clinically with weight loss, abdominal pain, nausea, and vomiting; weight loss and heavy alcohol use are most correlated with this lesion. On imagining it is described as a cystic-like pancreatic mass with duodenal wall thickening, which is concerning for a pancreatic cystic or solid neoplasm. Additional nomenclature includes: para-ampullary duodenal wall cyst, paraduodenal pancreatitis, cystic dystrophy of the duodenal wall, heteroptic pancreas, pancreatic hamartoma of the duodenum, paraduodenal wall cyst, and myodenomatosis.