Agrawal S, Vohra S. Simultaneous Courvoisier’s and double duct signs. World J Gastrointest Endosc 2017; 9(8): 425-427 [PMID: 28874964 DOI: 10.4253/wjge.v9.i8.425]
Corresponding Author of This Article
Shefali Agrawal, MD, MS, FACS, Senior Consultant, Hepatobiliary and Pancreatic Surgery, Department of Surgical Oncology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India. shefali_a@apollohospitals.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Aug 16, 2017; 9(8): 425-427 Published online Aug 16, 2017. doi: 10.4253/wjge.v9.i8.425
Simultaneous Courvoisier’s and double duct signs
Shefali Agrawal, Sandeep Vohra
Shefali Agrawal, Hepatobiliary and Pancreatic Surgery, Department of Surgical Oncology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India
Sandeep Vohra, Department of Radiology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India
Author contributions: Agrawal S contributed to study conception and design, acquisition of data, and drafting of manuscript; Agrawal S and Vohra S contributed to analysis and interpretation of data and critical revision.
Institutional review board statement: Not required.
Informed consent statement: As per our institutional policy, once all the information pertaining to the unique markers of the patient’s identity have been deleted from the case report, an informed consent from the patient is not necessary.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shefali Agrawal, MD, MS, FACS, Senior Consultant, Hepatobiliary and Pancreatic Surgery, Department of Surgical Oncology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India. shefali_a@apollohospitals.com
Telephone: +91-81-30009660
Received: December 28, 2016 Peer-review started: December 31, 2016 First decision: March 27, 2017 Revised: March 30, 2017 Accepted: April 23, 2017 Article in press: April 24, 2017 Published online: August 16, 2017 Processing time: 226 Days and 5.4 Hours
Abstract
Presence of Courvoisier’s or double duct signs in a jaundiced patient is suggestive of malignant obstruction of the pancreaticobiliary ductal system. The oncologic impact of the simultaneous occurrence of these signs on the survival of patients with periampullary cancer is unknown. We report a case of obstructive jaundice secondary to an ampullary cancer demonstrating the Courvoisier’s sign on clinical examination and a double duct sign on imaging. The patient underwent a pancreaticoduodenectomy which confirmed an ampullary adenocarcinoma.
Core tip: Presence of Courvoisier’s or double duct signs in a jaundiced patient is indicative of obstruction of the pancreaticobiliary ductal system most likely of malignant etiology. This study reports classic clinical and radiologic findings in ampullary adenocarcinoma. The oncologic impact of the simultaneous occurrence of these signs on the survival of patients with ampullary cancer is unknown.
