Abstract
BackgroundThe double-duct sign is defined as dilation of both the common bile duct and pancreatic duct, which usually indicates pancreatic malignancy. However, benign causes have also been reported to cause a double-duct sign.Case presentationWe present the case of a 59-year-old Caucasian female patient admitted to the Gastroenterology Department with intermittent right epigastric abdominal pain and an intact gallbladder. A double-duct sign was seen on endoscopic ultrasound. The suspicion of pancreatic malignancy was excluded through follow-up investigations. Biliary type II sphincter of Oddi dysfunction was diagnosed with an association of the double-duct sign. Sphincterotomy was performed to reduce pain, and there was no recurrence of symptoms during follow-up.ConclusionsThis is the third reported case in the literature of the double-duct sign associated with sphincter of Oddi dysfunction. This case emphasizes that the double-duct sign is not always caused by a local malignancy. The literature review of the reported cases has been summarized to help in the diagnosis of future similar cases.
Highlights
The double-duct sign is defined as dilation of both the common bile duct and pancreatic duct, which usually indicates pancreatic malignancy
This is the third reported case in the literature of the double-duct sign associated with sphincter of Oddi dysfunction
This case emphasizes that the double-duct sign is not always caused by a local malignancy
Summary
This is the third reported case in the literature of the double-duct sign associated with sphincter of Oddi dysfunction. This case emphasizes that the double-duct sign is not always caused by a local malignancy. The double-duct sign presents as dilation of the pancreatic duct and common bile duct on imaging studies This sign is considered menacing since the two most common causes are malignancies of either the pancreas or the ampulla of Vater [1]. We report the case of a 59-year-old female who presented with abdominal pain and was diagnosed with an unusual cause of the doubleduct sign. Endoscopic ultrasound (EUS) showed dilation of the common bile duct (CBD) (13.4 mm) (Fig. 1) and
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