Pancreatic adenocarcinoma - head/uncinate with double duct sign

Case contributed by Michael P Hartung
Diagnosis almost certain

Presentation

Abdominal discomfort.

Patient Data

Gender: Female

Some motion degradation on this study is noted. There is a ill-defined hypoenhancing pancreas head and uncinate process mass with dilation of the upstream pancreas duct and atrophy of the majority of parenchyma. There is moderate dilation of the bile ducts gallbladder, with rapid tapering of the common bile duct at the level of the pancreas head. Abutment of the superior mesenteric vein and portal splenic confluence but without significant venous narrowing. A very subtle small amount of soft tissue contacts the superior mesenteric artery, which appears occluded proximally and is likely reconstitutes via collaterals due to heavy amount of atherosclerotic disease in the upper abdomen. Small regional lymph nodes without suspicious upper abdominal lymph nodes. No liver lesions.

Case Discussion

Typical findings of pancreas adenocarcinoma with double duct sign including dilation of the pancreas duct with upstream atrophy and also dilation of the common bile duct, with additional staging details noted in the findings section.

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