Presentation
Abdominal pain and jaundice.
Patient Data
Intra and extrahepatic bile ducts are dilated and CBD measured 20 mm in caliber with homogeneous internal signal intensity and abrupt distal cut off. Pancreatic duct is also dilated up to 12 mm.
The gallbladder is distended without frank filling defect inferring stone or mass.
Case Discussion
Double duct sign; ERCP is needed for more evaluation.
The double duct sign refers to the presence of simultaneous dilatation of the common bile and pancreatic ducts. The two most common causes of the double duct sign are carcinoma of the head of the pancreas and ampullary tumors , although occasionally an impacted gallstone in the distal duct, with associated edema, can also result in obstruction of the pancreatic duct.
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