Courvoisier’s sign (or law) describes an enlarged, palpable gallbladder in patients with obstructive jaundice caused by tumors of the biliary tree or by pancreatic head tumors. This kind of biliary obstruction evolves slowly. The gall bladder will be dilated, with a thin wall; it is not tender to the touch. By contrast, acute cholecystitis due to obstruction by stone(s) is a quick process that causes a dilated gall bladder that is tender to the touch (Murphy's sign). The inflammation of chronic cholelithiasis results in a shrunken, fibrotic gallbladder.
Couvoisier’s sign can be found in patients with:
- biliary tumor (cholangiocarcinoma);
- periampulary carcinoma (adenocarcinoma of Vater papila or duodenum);
- pancreatic head cancer.;
- lymph node metastasis in the porta hepatis.
- BURKITT, H. George – QUICK, Clive R. G. Essential surgery : problems, diagnosis and management. 4. edition. Edinburgh ; New York : Churchill Livingstone, 2007. 793 pp. pp. 387,. ISBN 9780443103469.
- KASPER, Dennis L – FAUCI, Anthony S – LONGO, Dan L, et al. Harrison's principles of Internal Medicine. 16th edition. New York : McGraw-Hill Companies, Inc, 2005. 2607 pp. pp. 537. ISBN 0-07-139140-1.