Naseem Al-Khoury1, Okbah Mohamad2, Abd Al-Jawad Mazloum1, Maher Madi3,4. 1. Faculty of Medicine, Tishreen University, Latakia, Syria. 2. Faculty of Medicine, Tishreen University, Latakia, Syria. mohamadokbah@gmail.com. 3. Humboldt University, Berlin, Germany. 4. Department of Gastroenterology, Tishreen University Hospital, Latakia, Syria.
Abstract
BACKGROUND: The 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 PRESENTATION: We 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. CONCLUSIONS: 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 literature review of the reported cases has been summarized to help in the diagnosis of future similar cases.
BACKGROUND: The 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 PRESENTATION: We 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. CONCLUSIONS: 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 literature review of the reported cases has been summarized to help in the diagnosis of future similar cases.
Entities:
Keywords:
Background; Double-duct sign; Sphincter of Oddi dysfunction
Authors: Jose Behar; Enrico Corazziari; Moises Guelrud; Walter Hogan; Stuart Sherman; James Toouli Journal: Gastroenterology Date: 2006-04 Impact factor: 22.682