The inverted-3 sign of Frostberg or epsilon sign appears in gastroduodenal transit studies when the head of the pancreas tractions over the second part of the duodenum, thus eliminating the shape of the letter “C” and creating the shape of an epsilon (¿). It is observed in 3% of periampullary tumours and is not diagnostic as it can also be seen in pancreatitis or post-bulbar ulcers.
We present the case of a 70-year-old male patient with chronic pancreatitis who came to our consultation with digestive intolerance. Gastroduodenal transit study (Fig. 1) demonstrated this sign. After several diagnostic tests, malignancy was ruled out by endoscopic ultrasound guided fine needle aspiration.
Diagnosis
Chronic pancreatitis.
Please cite this article as: Ruiz Pardo J, Sánchez Bueno F, Torres Salmerón G, Parrilla Paricio P. El signo del «3 invertido» de Frostberg obliga a descartar malignidad. Cir Esp. 2015;93:e57.
