Curbside Consultation of the Pancreas: 49 Clinical Questions

Scott Tenner, MD, MPH; Alphonso Brown, MD, MS Clin Epi; Frank Gress, MD

Question 39: My Patient Had A Magnetic Resonance Cholangiopancreatography To Evaluate For Common Bile Duct Stones, But The Reading Includes A “Double Duct Sign.” What Does This Mean? Does It Need Endoscopic Retrograde Cholangiopancreatography? (continued)

Hui Hing (Jack) Tin, MD; Jai Mirchandani, MD

Although controversial in the past, the current accepted term, double duct sign, refers to narrowing of both the pancreatic and the common bile duct with dilatation of the ducts proximal to the site of narrowing. It is usually discovered through such studies such as magnetic resonance cholangiopancreatography (MRCP) (Figures 39-1 and 39-2), endoscopic retrograde cholangiopancreatography (ERCP), computed tomography (CT) scan (Figure 39-3), and transabdominal or endoscopic ultrasounds (EUS). These studies are usually prompted by obstructive jaundice and other signs and symptoms including…
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