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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]
The pancreatic duct or duct of Wirsung (also, the major pancreatic duct due to the existence of an accessory pancreatic duct) is a duct joining the pancreas to the common bile duct. This supplies it with pancreatic juice from the exocrine pancreas , which aids in digestion .
The pancreatic duct requires visualisation in cases of pancreatitis. Ultrasound is frequently the first investigation performed on admission; although it has little value in the diagnosis of pancreatitis or its complications. contrast-enhanced computed tomography (MD-CECT) is the most used imaging technique.
[3] [7] These sequences show high signal in static or slow moving fluids within the gallbladder, biliary ducts and pancreatic duct, with low signal of surrounding tissue. Secretin is also given to a patient to increase ductal compliance, making imaging easier. [3]
Bile ducts: 2. Intrahepatic bile ducts 3. Left and right hepatic ducts 4. Common hepatic duct 5. Cystic duct 6. Common bile duct 7. Ampulla of Vater 8. Major duodenal papilla 9. Gallbladder 10–11. Right and left lobes of liver 12. Spleen 13. Esophagus 14. Stomach 15. Pancreas: 16.
The ductal pancreas network originates from the central pancreatic duct—this main duct with the bile duct opens into the duodenum. The ductal cells of the main pancreatic duct are bound by connective tissue and produce a columnar epithelium. [3] Interlobular ducts originate from the main pancreatic duct and connect the various pancreatic lobes.
Gross pathology: Main duct, branch duct, and mixed duct lesions, which determines surgical management. Main duct lesion is the segmental or diffuse dilatation of main pancreatic duct greater than 5 mm without other causes of obstruction. Meanwhile, branch duct lesion is the pancreatic cyst more than 5 mm that communicates with the main duct.
When present, the sphincter is known as the sphincter of Helly, and the duct as the accessory pancreatic duct of Santorini. In 10% of people, the minor duodenal papilla is the prime duct for drainage of the pancreas, [1] although in others it may not be present at all. [2]