arodny1
Forum Newbie
Topics: 10
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Can someone explain courvoiser sign. when do patients get a palpable gallbladder? is it due to stones or malignancy?? :?:
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| bose
Forum Senior
Topics: 33
Posts: 162
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If I'm not mistaken, a large distended thin-walled gall bladder seen on ultrasound is 'Courvoiser Terrier' sign. It mostly occurs in association with malignancy (pancreatic head tumor, ampullary tumor or cholangiocarcinoma). Gallstones lead to a thick-walled gall bladders, not thin-walled.
Correct me if I'm wrong.
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| ELM
Forum Guru
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Bose is absolutely correct!
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ELM
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| CruiseMissile
Forum Junior
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Courvoisier's sign, if I'm not mistaken, is present on physical examination rather than on ultrasound. AFAIK, it means a patient presenting with jaundice, where the gallbladder is palpable, but not tender. The 'law' or implication at the very least is that the patient's disease is not due to stones, but usually a pancreatic or biliary tree malignancy.
Anyone want to weigh in?
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| mash
Forum Fanatic
Topics: 147
Posts: 1,326
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absolutely! painless palpable GB in a jaundiced pt is most likely due to ca head of pancreas or biliary tract ca.
and the reason is obstruction due to ca pancreas/biliary tree causes dilatation of GB (and is non tender)
on the other hand stones wud cause inflammation and chronic irritation wud lead to fibrosis so,thick walled GB wont be palpable(coz it wont be able to dilate)
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| Hamidi
Forum Guru
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The way I try to remember it is:
In case of malignancy something is obstructing c bileduct and GB is getting distended like a baloon.It is big and walls getting thin and shiny.Since bile is just collectng graduallyGB is not fightin it --->painless enlargment.
In case of Stones GB is trying to get rid of those, and walls getting thicker(like a body builder makes his/her muscle).Since it is not getting rid of stones(and bile)it gets enlarged.there is pain due to this sruggle and fight.
I don't know if this explaination is logical or not it helps me remember the picture. :wink: :idea:
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| doc_friend_india
Forum Junior
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the stone however is associated with inflammation=> fibrosis =>nonpalpable gall bladder ...that is not enlarged , but shrunken due to firbrosis
it is associated with tenderness since there has been inflammation
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great
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| gezira
Forum Junior
Topics: 13
Posts: 39
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am too late but i ve just read these topics :lol:
courvoiser law = in a jaundiced patient a palpable gallblader is most propably due to malignancy (ca panceas) full stop .
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good luck
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