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Courvoisier's Law — RACP Adult Medicine MCQ

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EasyGeneral Internal MedicineCourvoisier's LawRACP Adult Medicine

A 70-year-old woman presents with painless jaundice, weight loss, and a palpable gallbladder. CT shows a mass at the head of the pancreas. According to Courvoisier's law, what does a palpable gallbladder in the presence of jaundice suggest?

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Correct answer: B — Mirizzi syndrome

Courvoisier's law states that in the presence of jaundice, a palpable (non-tender, distended) gallbladder is unlikely to be due to gallstones and is more likely caused by malignant obstruction (typically pancreatic head carcinoma or cholangiocarcinoma). The rationale is that chronic gallstone disease causes a fibrotic, non-distensible gallbladder that cannot dilate, whereas malignant obstruction causes progressive painless distension of a previously normal gallbladder. While not absolute, it is a useful clinical sign.

Reference: eTG – 2025 – Gastrointestinal