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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]
Courvoisier's sign occurs due to the gradual (chronic) nature of the obstruction caused by cancer (e.g. pancreatic, often located in pancreatic head, cholangiocarcinoma, etc.), which gradually causes biliary back-pressure and gradually distends the gallbladder over time, without causing acute damage, thus without causing pain.
Pancreatic cancer is among the most deadly forms of cancer globally, with one of the lowest survival rates. In 2015, pancreatic cancers of all types resulted in 411,600 deaths globally. [8] Pancreatic cancer is the fifth-most-common cause of death from cancer in the United Kingdom, [19] and the third most-common in the United States. [20]
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The pancreatic duct is generally regarded as abnormally enlarged if being over 3 mm in the head and 2 mm in the body or tail on CT scan. [9] Pancreatic duct or parts of pancreatic duct can be demonstrated on ultrasound in 75 to 85% of people. [10] Pancreatic ductal carcinoma is a common form of pancreatic cancer.
Intraductal papillary mucinous neoplasm (IPMN) is a type of tumor that can occur within the cells of the pancreatic duct. IPMN tumors produce mucus, [1] and this mucus can form pancreatic cysts. [2] Although intraductal papillary mucinous neoplasms are benign tumors, they can progress to pancreatic cancer. [1]
Pancreaticoduodenectomy is most often performed as a curative treatment for periampullary cancer, which includes cancer of the bile duct, duodenum, ampulla or head of the pancreas. [4] The shared blood supply of the pancreas, duodenum and common bile duct necessitates en bloc resection of these multiple structures.
Autoimmune pancreatitis may cause a variety of symptoms and signs, which include pancreatic and biliary (bile duct) manifestations, as well as systemic effects of the disease. Two-thirds of patients present with either painless jaundice due to bile duct obstruction or a "mass" in the head of the pancreas, mimicking carcinoma.