Double duct sign

Changed by Mohammad Taghi Niknejad, 9 Oct 2022

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The double duct sign refers to the presence of simultaneous dilatation of the common bile and pancreatic ducts. Being an anatomical sign it can be seen on all modalities that can visualise the region, including: MRI, CT, ultrasound and endoscopic retrograde cholangiopancreatography (ERCP). In general, the double duct sign represents a malignant cause until disproved.

Pathology

Aetiology

Common

Less common

malignant
- cholangiocarcinoma of the CBD
- lymphoma
- metastases
impacted gallstone in distal duct, with associated oedema, resulting in pancreatic duct obstruction
chronic pancreatitis
ampullary stenosis

Rare

Case reports ^1-3

-The double duct sign refers to the presence of simultaneous dilatation of the common bile and pancreatic ducts. Being an anatomical sign it can be seen on all modalities that can visualise the region, including: MRI, CT, ultrasound and endoscopic retrograde cholangiopancreatography (ERCP). In general, the double duct sign represents a malignant cause until disproved.<h4>Pathology</h4><h5>Aetiology</h5>Common<ul>
~~-<li><a href="/articles/pancreatic-ductal-adenocarcinoma-2">carcinoma of the head of the pancreas</a></li>~~
~~-<li>~~
~~-<a href="/articles/ampullary-tumour">ampullary tumours </a>(e.g. <a href="/articles/ampullary-adenocarcinoma">carcinoma of the ampulla of Vater</a>)</li>~~
~~-</ul>Less common<ul>~~
~~-<li>malignant<ul>~~
~~-<li>cholangiocarcinoma of the CBD</li>~~
~~-<li>lymphoma</li>~~
~~-<li>metastases</li>~~
~~-</ul>~~
~~-</li>~~
~~-<li>~~
~~-<a href="/articles/choledocholithiasis">impacted gallstone in distal duct</a>, with associated oedema, resulting in pancreatic duct obstruction</li>~~
~~-<li><a href="/articles/chronic-pancreatitis-2">chronic pancreatitis</a></li>~~
~~-<li>ampullary stenosis</li>~~
~~-</ul>RareCase reports 1-3<ul>~~
~~-<li><a href="/articles/idiopathic-retroperitoneal-fibrosis">primary retroperitoneal fibrosis</a></li>~~
~~-<li><a href="/articles/kaposi-sarcoma">Kaposi sarcoma</a></li>~~
~~-<li>~~
~~-<a href="/articles/sphincter-of-oddi-dysfunction">sphincter of Oddi dysfunction</a> 3~~
~~-</li>~~
+The double duct sign refers to the presence of simultaneous dilatation of the common bile and pancreatic ducts. Being an anatomical sign it can be seen on all modalities that can visualise the region, including: MRI, CT, ultrasound and endoscopic retrograde cholangiopancreatography (ERCP). In general, the double duct sign represents a malignant cause until disproved.<h4>Pathology</h4><h5>Aetiology</h5>Common<ul>
+<li><a href="/articles/pancreatic-ductal-adenocarcinoma-4">carcinoma of the head of the pancreas</a></li>
+<li>
+<a href="/articles/ampullary-tumour">ampullary tumours </a>(e.g. <a href="/articles/ampullary-adenocarcinoma">carcinoma of the ampulla of Vater</a>)</li>
+</ul>Less common<ul>
+<li>malignant<ul>
+<li>cholangiocarcinoma of the CBD</li>
+<li>lymphoma</li>
+<li>metastases</li>
+</ul>
+</li>
+<li>
+<a href="/articles/choledocholithiasis">impacted gallstone in distal duct</a>, with associated oedema, resulting in pancreatic duct obstruction</li>
+<li><a href="/articles/chronic-pancreatitis-2">chronic pancreatitis</a></li>
+<li>ampullary stenosis</li>
+</ul>RareCase reports 1-3<ul>
+<li><a href="/articles/idiopathic-retroperitoneal-fibrosis">primary retroperitoneal fibrosis</a></li>
+<li><a href="/articles/kaposi-sarcoma">Kaposi sarcoma</a></li>
+<li>
+<a href="/articles/sphincter-of-oddi-dysfunction">sphincter of Oddi dysfunction</a> 3
+</li>

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Image 13 CT (C+ arterial phase) ( create )

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Double duct sign

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Image 13 CT (C+ arterial phase) ( create )

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