Courvoisier’s sign

Severe jaundice with a palpable, non-tender gallbladder, indicating obstruction of biliary passages from something other than a gallstone, possibly a tumor.

The term describes the physical examination finding of the right-upper quadrant of the abdomen, and suggests possible malignancy of the gall bladder or pancreas and unlikely to be due to gallstones.

Gallstones are formed over an extended period of time, resulting in a shrunken, fibrotic gall bladder which does not distend and is not palpable.

The gallbladder is more often enlarged in clinical processes that cause obstruction of the biliary tree over a shorter period of time such as pancreatic malignancy leading to passive distention.

A palpable tender gallbladder may be seen in acute acalculous cholecystitis, which commonly follows trauma or ischemia and causes acute inflammation of the gallbladder in the absence of gallstones.

Tumors that obstruct the common bile duct result in an enlarged gall bladder.

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