Carcinoma of the pancreatic head most commonly leads to obstructive jaundice and dilation of both the common bile duct and pancreatic duct. This combination of dilated ducts is referred to as:

• A Courvoisier sign
• B Double duct sign ✓
• C Trousseau sign
• D Murphy sign

Explanation

The 'double duct sign' on ERCP or MRCP refers to simultaneous dilation of both the common bile duct and the main pancreatic duct, strongly suggesting a periampullary or pancreatic head malignancy obstructing both ductal systems. Courvoisier sign is the clinical finding of a palpable, non-tender gallbladder in a jaundiced patient, suggesting malignant biliary obstruction (in contrast to gallstone disease where the gallbladder is fibrosed and not palpable). Trousseau sign is migratory thrombophlebitis associated with pancreatic cancer. Murphy sign is inspiratory arrest on palpating the right hypochondrium, seen in acute cholecystitis.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.