The Common Vein Copyright 2008

Courvoisier Gallbladder, somtimes called Couvoisier’s sign, refers to a palpable gallbladder, in the absence of pain.

It is a manifestation of a distended gallbladder, caused by a distal obstruction of the common bile duct.

It is associated with carcinoma of the common bile duct.

 

Ludwig Courvoisier

This image of Ludwig Courvoisier (1843-1918), who was a surgeon who described ‘Courvoisier’s law’ – ‘if in the presence of jaundice the gallbladder is palpable, then the jaundice is unlikely to be due to a stone.’ This was first published in his book ‘The pathology and surgery of the gallbladder’ in Leipzig in 1890. 54478 Origin of this photo from surgical tutor.org a free on line resource and may be subject to copyright http://www.surgical-tutor.org.uk/default-home.htm?surgeons/courvoisier.htm~right code gallbladder historical pancreas carcinoma clinical portrait

Courvoisier Gallbladder

44005c01.8s elderly patient presents with painless jaundice Courvoisier gallbladder distended enlarged dilated pancreatic duct pancreas mass pancreatic carcinoma CTscan percutaneous cholangiogram PTC Courtsy Ashley DAvidoff MD copyright 2008 bile duct

Courvoisier Gallbladder

78441c01.8s painless jaundice pancreas mass bile ducts intrahepatic dilated extrahepatic gallbladder enlarged distended dilated gallstones cholelithiasis pancreatic duct double duct sign Courvoisier’s CTscan Courtesy Ashley Davidoff MD copyright 2008

Courvoisier’s Gallbladder

04655.8s 57 year old female presents with jaundice Courtesy Ashley Davidoff MD gallbladder dilated distended bile duct intrahepatic bile duct ampullary carcinoma imaging radiology CTscan neoplasm malignant primary tumor cancer mechanical Courtesy Ashley DAvidoff MD copyright 2008

Ampullary Carcinoma

57 year old female presents with jaundice 04655c02 Courtesy Ashley Davidoff MD code liver fx nodule bile duct intrahepatic bile duct extrahepatic bile duct fx dilated “too many ducts” sign pancreas pancreatic duct fx dilated double duct sign code dx ampullary carcinoma imaging radiology CTscan neoplasm malignant primary tumor cancer mechanical

Ampullary Carcinoma

57 year old female presents with jaundice 04655c05 Courtesy Ashley Davidoff MD code liver fx nodule bile duct intrahepatic bile duct extrahepatic bile duct fx dilated “too many ducts” sign pancreas pancreatic duct fx dilated double duct sign code dx ampullary carcinoma imaging radiology USscan CTscan grosspathology neoplasm malignant primary tumor cancer mechanical