Double duct sign
Disclosures
- updated 24 Apr 2022:
Nothing to disclose
Updates to Article Attributes
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was changed:
The double duct sign refers to the presence of simultaneous dilatation of the common bile and pancreatic ducts. Being an anatomical sign it can be seen on all modalities that can visualise the region, including: MRI, CT, ultrasound and endoscopic retrograde cholangiopancreatography (ERCP).
The two most common causes of In general, the double duct sign are represents a malignant cause until disproved.
Pathology
Aetiology
Common
-
carcinoma of the head of the pancreas
and -
ampullary tumours (e.g. carcinoma of the ampulla of Vater)
, although occasionally an
Less common
-
malignant
- cholangiocarcinoma of the CBD
- lymphoma
- metastases
-
impacted gallstone in
thedistal duct, with associated oedema,can also resultresulting inobstruction of thepancreatic duct.obstruction - chronic pancreatitis
- ampullary stenosis
Rare
Case reports 1-3
-<p>The <strong>double duct sign</strong> refers to the presence of simultaneous dilatation of the common bile and pancreatic ducts. Being an anatomical sign it can be seen on all modalities that can visualise the region, including: MRI, CT, ultrasound and endoscopic retrograde cholangiopancreatography (ERCP). </p><p>The two most common causes of the double duct sign are <a href="/articles/pancreatic-ductal-adenocarcinoma-2">carcinoma of the head of the pancreas</a> and <a href="/articles/ampullary-tumour">ampullary tumours </a>(e.g. <a href="/articles/ampullary-adenocarcinoma">carcinoma of the ampulla of Vater</a>), although occasionally an impacted gallstone in the distal duct, with associated oedema, can also result in obstruction of the pancreatic duct. </p>- +<p>The <strong>double duct sign</strong> refers to the presence of simultaneous dilatation of the common bile and pancreatic ducts. Being an anatomical sign it can be seen on all modalities that can visualise the region, including: MRI, CT, ultrasound and endoscopic retrograde cholangiopancreatography (ERCP). In general, the double duct sign represents a malignant cause until disproved.</p><h4>Pathology</h4><h5>Aetiology</h5><p><strong>Common</strong></p><ul>
- +<li><a href="/articles/pancreatic-ductal-adenocarcinoma-2">carcinoma of the head of the pancreas</a></li>
- +<li>
- +<a href="/articles/ampullary-tumour">ampullary tumours </a>(e.g. <a href="/articles/ampullary-adenocarcinoma">carcinoma of the ampulla of Vater</a>)</li>
- +</ul><p><strong>Less common</strong></p><ul>
- +<li>malignant<ul>
- +<li>cholangiocarcinoma of the CBD</li>
- +<li>lymphoma</li>
- +<li>metastases</li>
- +</ul>
- +</li>
- +<li>
- +<a href="/articles/choledocholithiasis">impacted gallstone in distal duct</a>, with associated oedema, resulting in pancreatic duct obstruction</li>
- +<li><a href="/articles/chronic-pancreatitis-2">chronic pancreatitis</a></li>
- +<li>ampullary stenosis</li>
- +</ul><p><strong>Rare</strong></p><p>Case reports <sup>1-3</sup></p><ul>
- +<li><a href="/articles/idiopathic-retroperitoneal-fibrosis">primary retroperitoneal fibrosis</a></li>
- +<li><a href="/articles/kaposi-sarcoma">Kaposi sarcoma</a></li>
- +<li>
- +<a href="/articles/sphincter-of-oddi-dysfunction">sphincter of Oddi dysfunction</a> <sup>3</sup>
- +</li>
- +</ul>
References changed:
- 2. Lorenzo D, Verset L, Devière J. Jaundice and Double-Duct Sign: Always Cancer? Endosc Ultrasound. 2022;11(1):77-8. <a href="https://doi.org/10.4103/EUS-D-20-00240">doi:10.4103/EUS-D-20-00240</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/34213430">Pubmed</a>
- 3. Al-Khoury N, Mohamad O, Mazloum A, Madi M. Biliary Type-II Sphincter of Oddi Dysfunction with a Pancreatic Duct Dilation: A Case Report and Review of The literature. J Med Case Rep. 2021;15(1):82. <a href="https://doi.org/10.1186/s13256-021-02674-z">doi:10.1186/s13256-021-02674-z</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/33612115">Pubmed</a>
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