Simultaneous Courvoisier?s and Double Duct Signs

Presence of Courvoisier’s or double duct signs in a jaundiced patient is suggestive of malignant obstruction of the pancreaticobiliary ductal system however; the oncologic significance of the simultaneous occurrence of these signs is unknown. We report a case of obstructive jaundice secondary to a periampullary tumor demonstrating the Courvoisier’s sign on clinical examination and a double duct sign on imaging who underwent a Whipple operation which confirmed an ampullary adenocarcinoma.