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CT images shows irregular hypovascular mass in ampulla and associated marked dilatation of common and intrahepactic bile ducts. The pancreatic duct is not dilated. No upstream pancreatic atrophy.
Normal fat planes preserved around major abdominal aortic branches.
This case shows a lesion of the ampulla of Vater however the double duct sign is not displayed. This sign, seen in the majority of tumors of the ampulla of Vater, consists of a dilated pancreatic duct and common bile duct at the same time. A normal-sized pancreatic duct does not however exclude the diagnosis of ampullary neoplasm because the ductal caliber will be normal in up to 50% in patients with bile duct obstruction caused by an ampullary tumour.
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- 2. Pham DT, Hura SA, Willmann JK et-al. Evaluation of periampullary pathology with CT volumetric oblique coronal reformations. AJR Am J Roentgenol. 2009;193 (3): W202-8. doi:10.2214/AJR.08.2069 - Pubmed citation