Double duct sign

Last updated

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. [1] The double duct sign is most commonly visualized on imaging modalities such as computed tomography, magnetic resonance imaging, or endoscopic retrograde cholangiopancreatography.

Contents

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. [1] [2]

Imaging features

Clinical significance

The double duct sign is a red flag finding in radiology, with malignancies accounting for the majority of cases. Early identification is crucial for diagnosis, staging in case of malignancy, management and for performing therapeutic interventions.

References

  1. 1 2 Ahualli, Jorge (July 2007). "The Double Duct Sign" . Radiology. 244 (1): 314–315. doi:10.1148/radiol.2441041978. ISSN   0033-8419. PMID   17581912 . Retrieved 2 January 2025.
  2. Sinha, Rohit; Gardner, Terri; Padala, Krishnaveni; Greenaway, John Richard; Joy, Diamond (August 2015). "Double-Duct Sign in the Clinical Context" . Pancreas. 44 (6): 967–970. doi:10.1097/MPA.0000000000000372. ISSN   0885-3177. PMID   26087354 . Retrieved 2 January 2025.
  3. Oterdoom, LH; van Weyenberg, SJ; de Boer, NK (December 2013). "Double-duct sign: do not forget the gallstones". Journal of Gastrointestinal and Liver Diseases. 22 (4): 447–50. PMID   24369328.
  4. Yao, Lu; Amar, Hoda; Aroori, Somaiah (29 February 2024). "Incidental double duct sign: Should we be worried? Results from a long-term follow-up study". Annals of Hepato-Biliary-Pancreatic Surgery. 28 (1): 53–58. doi:10.14701/ahbps.23-063. PMC   10896684 . PMID   37914668 . Retrieved 2 January 2025.