Double duct sign
radiologic sign
The double duct sign is a radiological finding characterized by the simultaneous dilation of the common bile duct and the main pancreatic duct. This sign is significant because it often indicates an obstruction in the distal bile duct and pancreatic duct, frequently caused by serious underlying pathologies such as pancreatic carcinoma or periampullary tumors. The double duct sign is most commonly visualized on imaging modalities such as computed tomography, magnetic resonance imaging, or endoscopic retrograde cholangiopancreatography.
Pathophysiology
The double duct sign results from the anatomical convergence of the biliary and pancreatic ducts at the ampulla of Vater, where obstructions can disrupt the drainage of both systems simultaneously. Common causes of such obstructions include pancreatic adenocarcinoma, periampullary cancer, cholangiocarcinoma, chronic pancreatitis, gallstone-related obstruction and strictures.
Imaging features
Ultrasound: May show dilated common bile duct and main pancreatic duct, but is less reliable in visualizing both ducts simultaneously.
Computed Tomography: Non-contrast and contrast-enhanced CT may demonstrate dilation of both ducts and identify an underlying mass in the pancreas or ampulla, if present.
Magnetic Resonance Cholangiopancreatography (MRCP): Non-invasive procedure, that clearly shows dilated CBD and MPD and may help pinpoint the obstruction site.
Endoscopic Retrograde Cholangiopancreatography (ERCP): A diagnostic and therapeutic tool, ERCP provides high-resolution imaging of the biliary and pancreatic ducts. It is particularly useful for biopsy or stenting if malignancy is suspected.
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This entry incorporates text from “Double duct sign” on English Wikipedia. Contributors are listed in the page history. Text is available under the Creative Commons Attribution-ShareAlike 4.0 License. Selected authority identifiers and statements are retrieved from Wikidata under CC0; their references and qualifiers remain part of the verification path.