Courvoisier's law

Courvoisier's law (also known as Courvoisier's sign or Courvoisier's rule) is a medical rule that states that in the presence of a palpable gallbladder in a jaundiced patient, the cause is unlikely to be gallstones. This rule is named after the Swiss surgeon Ludwig Georg Courvoisier who first described it.

History

Ludwig Georg Courvoisier (1843–1918) was a Swiss surgeon who first described the rule that bears his name. He made significant contributions to the field of surgery, particularly in the area of gallbladder diseases.

Explanation

Courvoisier's law is based on the principle that if the gallbladder is palpable in a patient with jaundice, it is unlikely that the cause of the jaundice is gallstones. This is because gallstones typically cause the gallbladder to shrink due to chronic inflammation, making it non-palpable. Therefore, a palpable gallbladder in a jaundiced patient suggests a different cause, such as a tumor in the head of the pancreas or the ampulla of Vater.

Clinical significance

Courvoisier's law is used in the differential diagnosis of jaundice. It helps to distinguish between obstructive jaundice caused by gallstones and that caused by other conditions such as pancreatic or ampullary tumors. However, it is not a definitive diagnostic tool and further investigations such as imaging studies and blood tests are usually required to confirm the diagnosis.

See also

• Jaundice
• Gallstones
• Pancreatic cancer
• Ampulla of Vater