Dilated Cystic Duct with Spiral Valves of Heister on POCUS

Older male with RUQ/midepigastric pain with jaundice. What is the candy cane looking structure?
Answer: Obstructing mass at head of pancreas (pancreatic CA) with intra and extra-hepatic ductal dilatation. Candy cane looking structure is dilated cystic duct with spiral valves of Heister seen. Additionally has gallstones but no obstructing stone seen on MRCP. Best example of Spiral Valves of Heister in dilated cystic duct I have found to date. 

Dr. Robert Jones @RJonesSonoEM

#CysticDuct #Dilated #Spiral #Valves #Heister #POCUS #clinical #ultrasound #biliary