Demographics:
53 years old, Female
Indication:
Jaundice, negative sonographic Murphy sign
Findings
- Dilated main pancreatic duct, measuring up to 8 mm in diameter, with an ill-defined hypoechoic mass in the pancreatic head measuring 2.9 x 2.7 x 2.4 cm
- Extrahepatic biliary duct dilation with the common bile duct measuring up to 11 mm in diameter and echogenic material noted in the distal common bile duct
- Borderline gallbladder wall thickening and mild gallbladder distension with layering gallstones and sludge
- Normal appearance of the liver and right kidney
- No ascites
- Visualized portions of the abdominal aorta are normal in caliber
Diagnosis
Pancreatic adenocarcinoma
Sample Report
Dilated main pancreatic and common bile ducts ("double duct sign") with an ill-defined hypoechoic mass in the pancreatic head measuring 2.9 x 2.7 x 2.4 cm, concerning for pancreatic malignancy. Recommend surgical consultation and contrast-enhanced CT for further assessment.
Echogenic material layering in the distal common bile duct, which may represent sludge; however, recommend correlation with clinical signs of ascending cholangitis.
Borderline gallbladder wall thickening and mild gallbladder distension with layering gallstones and sludge, which are favored secondary to distal biliary obstruction rather than acute cholecystitis.
Discussion