Courvoisier Law and the Pain - Jaundice combination - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum > USMLE Step 2 CK High Yield > USMLE Step 2 CK Bits & Pieces

USMLE Step 2 CK Bits & Pieces High yield short focused points, monographs, charts, illustrations, tables, and other stuff related to the USMLE Step 2 CK Exam.


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 05-06-2010
Ex-USMLE Forums Staff
 
Steps History: 1+CK+CS+3
Posts: 753
Threads: 106
Thanked 2,166 Times in 464 Posts
Reputation: 2214
GIT Courvoisier Law and the Pain - Jaundice combination

Courvoisier Laws:

Courvoisier Law states that an enlarged gallbladder which is painless is more likely to be due obstruction by carcinoma than by gall stones.

Courvoisier-Terrier sign on the other hand states that a dilated gall bladder in a jaundiced patient is likely to be due to tumor as opposed to non-dilated bladder which is usually due to stone obstruction.

Pain-Jaundice combination:

The idea is this,
Stone obstruction is usually acute and the gallbladder will contract in an attempt to override the obstruction and this will increase the intraluminal pressure causing the pain. (Charcot Triad = Fever + Pain + Jaundice)

While in carcinoma, whether it's cholangiocarcinoma or carcinoma of the head of the pancreas will cause a gradual obstruction and the gallbladder will not be so reactive and therefore these conditions will be painless.

However, in both the situations you have blocked the flow of bile and you have to have conjugated hyperbilirubinemia. Only one exception where you don't have jaundice, which is if the stone is lodged in the cystic duct, in this case you have pain but no jaundice because the bile can still flow from the hepatic ducts to the common bile ducts.

In summery;
Pain + Jaundice ---> think gall stones
Pain + No Jaundice ---> think cystic duct stone
No Pain + Jaundice ---> think carcinoma
Reply With Quote Quick reply to this message
The above post was thanked by:
agonist (05-07-2015), chienpolska (09-15-2011), dinosaur108 (07-12-2012), docoftheworld (05-29-2011), drlmorice (12-13-2012), drsrb (11-04-2013), Future Radiolog (02-03-2011), gyst (10-30-2011), jdigan1 (11-11-2012), kajol1 (01-22-2011), Krazy (11-14-2013), Mondoshawan (01-22-2011), nakeya52 (04-26-2014), paul_87 (05-13-2013), renew (08-07-2011), Seisamodupi (08-06-2014), Taiwan_Guy (12-04-2010), vita86 (09-24-2014), voicesinmyhead (10-23-2014), withoutlimits (05-07-2011)



  #2  
Old 06-08-2010
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 3,317
Threads: 170
Thanked 4,878 Times in 1,808 Posts
Reputation: 4931
Smile Name confusion

Don't confuse Courvoisier with Couvelaire
Here's the Couvelaire thread
Reply With Quote Quick reply to this message
The above post was thanked by:
dinosaur108 (07-12-2012), docoftheworld (05-29-2011), Taiwan_Guy (12-04-2010)



Reply

Tags
Clinical-Signs, Gastroenterology-, Surgery-

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
The cause of this jaundice FreakingOut USMLE Step 1 Forum 5 04-10-2013 10:32 PM
Kaplan + FA is the ultimate combination RRMadukha USMLE Step 2 CS Forum 0 04-24-2010 03:44 AM
breast milk jaundice sharvaree19 USMLE Step 2 CK Forum 1 04-11-2010 08:59 AM
Gall Bladder Pain Jaundice Combinations wonder USMLE Step 1 Forum 2 12-21-2009 08:08 PM
Jaundice Cataract after birth Sarah-cali USMLE Step 1 Classic Clues 1 07-27-2009 09:52 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)