Which statement best describes the Courvoisier sign?

Which statement best describes the Courvoisier sign?

• A. Palpable, non-tender gallbladder with painless jaundice
• B. Palpable, tender gallbladder with painful jaundice
• C. Courvoisier sign refers to a palpable non-tender gallbladder with painless jaundice
• D. Normal gallbladder with obstructive symptoms

Answer: (C)

Courvoisier sign is the finding of a palpable, non-tender gallbladder in the setting of jaundice. This points to obstruction of the distal biliary tree by a malignancy, most classically pancreatic head cancer or cholangiocarcinoma. The obstruction causes the gallbladder to distend, producing a palpable lump, but because there isn’t acute inflammation, the gallbladder is not tender. This helps distinguish it from conditions like acute cholecystitis, where the gallbladder is tender and jaundice, if present, is typically not painless. A normal-sized gallbladder with obstructive symptoms wouldn’t fit the sign.

Courvoisier sign is the finding of a palpable, non-tender gallbladder in the setting of jaundice. This points to obstruction of the distal biliary tree by a malignancy, most classically pancreatic head cancer or cholangiocarcinoma. The obstruction causes the gallbladder to distend, producing a palpable lump, but because there isn’t acute inflammation, the gallbladder is not tender. This helps distinguish it from conditions like acute cholecystitis, where the gallbladder is tender and jaundice, if present, is typically not painless. A normal-sized gallbladder with obstructive symptoms wouldn’t fit the sign.