Presentation
Abdominal pain and elevated liver enzymes.
Patient Data
Age: 75 years
Gender: Male
From the case:
Double duct sign
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The gallbladder is not seen at the anatomical location due to prior resection.
Intra and extra hepatic bile ducts are dilated, and CBD measured 17 mm in caliber with homogenous internal signal intensity and distal abrupt cutoff. The pancreatic duct is also dilated. (Double duct sign)
A 15 mm low signal mass like filling defect is evident at the distal of CBD.
Case Discussion
The patient underwent ERCP and biopsy, and histopathology evaluation confirmed ampullary adenocarcinoma which is a rare biliary tumor arising from the distal biliary epithelium at the ampulla of Vater.