Double duct sign

Case contributed by Mohammad Taghi Niknejad
Diagnosis almost certain

Presentation

Abdominal pain and jaundice.

Patient Data

Age: 50 years
Gender: Female
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Intra and extra hepatic bile ducts and the main pancreatic duct are dilated, and there is a 27 mm ill-defined low-enhancing mass at the pancreatic head. No sign of local invasion, no vascular encasement, and no regional enlarged lymph node.

Case Discussion

The patient underwent endoscopic ultrasonography and FNA. Then Whipple procedure was performed, and histopathology evaluation confirmed pancreatic ductal adenocarcinoma.

The double duct sign refers to simultaneous dilatation of the common bile and pancreatic ducts and often represents a malignant cause until disproved.

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