A 62-year-old man presents with painless progressive jaundice and weight loss. Contrast-enhanced CT shows simultaneous dilatation of both the common bile duct and the main pancreatic duct with abrupt tapering at their confluence. This 'double duct' sign is most characteristic of:
- A Carcinoma of the head of the pancreas ✓
- B Choledocholithiasis at the ampulla of Vater
- C Chronic calcific pancreatitis
- D Cholangiocarcinoma of the common hepatic duct
Correct answer: A. Carcinoma of the head of the pancreas
Explanation
Simultaneous dilatation of the common bile duct and pancreatic duct indicates obstruction near the ampulla, and in an elderly patient with painless jaundice it is classic for carcinoma of the pancreatic head. A stone causes acute colicky biliary pain with fluctuating jaundice and typically dilates only the bile duct. Chronic pancreatitis gives irregular beaded duct dilatation with intraductal calculi, not abrupt tapering at a single point.
Reference: Grainger and Allison Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.