A 57-year-old male with a history of chronic pancreatitis related to heavy smoking and alcohol abuse was evaluated in the emergency department due to a 3-day history of epigastric pain and postprandial vomiting. Abdominal computed tomography (CT) was performed and revealed a severe gastric dilation that reached the pelvis. There was a marked concentric mural thickening at the duodenal level and an intramural cysts that caused a narrowing of the light and a retrograde gastric dilation. There were no findings suggestive of chronic pancreatitis. A diagnosis was made of duodenal obstruction due to groove pancreatitis with severe secondary gastric dilatation.