Malignant biliary obstruction - Courvoisier sign

Case contributed by Dr Chris O'Donnell

Presentation

Right upper quadrant mass with painless jaundice.

Patient Data

Age: 75 years
Gender: Male

Distended gallbladder and common bile duct to the level of the pancreatic head, where there is a mass. 

Distended gall bladder and biliary tree down to the distal end where there is a small (3 cm) pancreatic head mass. Note also pancreatic duct enlargement.

Case Discussion

Courvoisier sign states that in the presence of an enlarged gallbladder which is non-tender and accompanied by jaundice, the cause is unlikely to be gallstones and suspicious for pancreatic/periampullary malignant mass obstructing distal CBD. Here we have the CT and US correlates.

It is usually used to describe the physical examination finding of a painless right-upper quadrant mass in the abdomen in a jaundiced patient.   

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Case information

rID: 19227
Published: 18th Aug 2012
Last edited: 8th Jun 2019
Inclusion in quiz mode: Included

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