Courvoisier's law
Pronunciation: koor-vwa-ZYAY
A clinical principle stating that a palpable gallbladder in the presence of jaundice is unlikely to be due to gallstones.
Full Definition
Courvoisier's law is a fundamental clinical principle in hepatobiliary medicine that states 'if in the presence of jaundice the gallbladder is palpable, then the jaundice is unlikely to be due to a stone.' This observation is based on the pathophysiology that chronic gallstone disease typically causes gallbladder fibrosis and scarring, preventing distension even when the bile duct is obstructed. In contrast, malignant obstruction (such as from pancreatic or bile duct cancer) occurring in a previously normal gallbladder allows for distension. However, the law has exceptions and is not absolute, as some patients with gallstones may still present with a palpable gallbladder, particularly if the obstruction is acute.
Usage
Usage note: Named after Swiss surgeon Ludwig Georg Courvoisier; capitalize the eponym and use apostrophe.
In Context
- "The presence of painless jaundice with a palpable gallbladder supported Courvoisier's law, suggesting malignant biliary obstruction rather than choledocholithiasis." — Clinical assessment note
- "Courvoisier's law guided the differential diagnosis toward pancreatic head malignancy in this patient with obstructive jaundice." — Gastroenterology consultation