title: Opium-related sphincter of Oddi dysfunction causing double duct sign.
abstract: Double duct sign where there is a simultaneous dilatation of both the common bile duct (CBD) and pancreatic duct is usually associated with sinister causes like malignancies of pancreatic head or ampulla. Occasionally, benign causes like chronic pancreatitis or sphincter of Oddi dysfunction (SOD) may cause double duct sign. Chronic opium abuse is a rare cause of the double duct sign, and endoscopic ultrasound (EUS) findings of this rare entity have been occasionally reported. We report about a 54-year-old male with a history of chronic alcohol and opioid abuse evaluated for episodes of abdominal pain and found to have opioid-related SOD and improved with biliary sphincterotomy. EUS was done to rule out malignancy and revealed hypoechoic prominence around terminal CBD suggestive of hypertrophied muscle.
authors: Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Vishal
authors: V
authors: Sharma
authors: Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Surinder Singh
authors: SS
authors: Rana
authors: Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Vinita
authors: V
authors: Chaudhary
authors: Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Narendra
authors: N
authors: Dhaka
authors: Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Manish
authors: M
authors: Manrai
authors: Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Jegan
authors: J
authors: Sivalingam
authors: Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Ravi
authors: R
authors: Sharma
authors: Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Usha
authors: U
authors: Dutta
authors: Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Deepak Kumar
authors: DK
authors: Bhasin