Courvoisiers law
This states that: in the presence of (obstructive)jaundice, if the gall Bladder is palpable, then the jaundice is unlikely to be due to gall stones. This is because the gall Bladder is usually shrunken and thick walled with gallstones and connot easily distend. There are two exceptions to this rule
1)A mirizzi syndrome, where a stone is lodged in Hartman’s pouch causeing intense inflamation in the region of Calots triangle and compressing the common hepatic duct, while also obstructing the gall bladder; this causes the gall Bladder to distend
2) Where there are 2 stones causing problems, one in the common bile duct, obstructing the flow of bile with consequent obstructive jaundice. Accompanying this is a synchronous stone obstructing the gall Bladder causing a mucocoele or empyema of the gall Bladder
Other Exceptions are: 1. Pancreatic calculus obstructing the ampulla of Vater. 2. Oriental cholangiohepatitis
Dictionary > Courvoisiers law
