Imaging insights into the complexities of groove pancreatitis: Six case series

Abstract Background Groove pancreatitis (GP) is a rare form of chronic pancreatitis affecting the pancreaticoduodenal groove and often mimicking pancreatic or duodenal malignancies. Its imaging manifestations vary by morphological subtype—pure or segmental—and by the degree of inflammatory or fibrotic change. Early and accurate radiologic identification is essential to ensure appropriate conservative management and prevent unnecessary surgical resections. Aim of the work To describe key CT imaging findings of GP across six cases and highlight features that help differentiate it from pancreatic cancer. Results Six patients (35–65 years; 5 males) underwent multiphasic contrast-enhanced CT. All presented with abdominal pain; distension (4/6), vomiting (3/6), food intolerance (2/6), and jaundice-related symptoms (2/6) were variably present. Imaging showed medial duodenal wall thickening and hyperenhancement in all cases, duodenal luminal narrowing in two, and cystic changes in one. Soft tissue thickening in the groove appeared in 5/6 cases, with variable GDA displacement. Pancreatic head involvement occurred in three, and CBD dilatation in two. Three cases were categorized as segmental GP and three as pure GP. All improved with conservative management. Conclusions Characteristic CT findings—duodenal wall thickening, groove soft tissue changes, absence of vascular encasement, and occasional cysts—allow reliable differentiation of GP from malignancy. Recognizing these patterns supports accurate diagnosis and prevents unnecessary surgical intervention.