The Courvoisier sign, sometimes called Courvoisier’s law, refers to a gallbladder that’s enlarged due to bile buildup. When this happens, you can usually see or feel your gallbladder through your skin.
Usually, your gallbladder releases bile into your digestive system. This helps your body process fats. If bile production is somehow blocked, your gallbladder fills up with bile and expands.
What are the symptoms?
The main symptom of the Courvoisier sign is an enlarged gallbladder that you can feel through your skin. In most cases, it doesn’t cause any pain.
You might also notice symptoms of jaundice, which is a yellow tint in your skin or eyes. While this can look alarming, it’s not always a cause for concern, and it’s a common symptom of many gallbladder conditions.
The Courvoisier sign results from blockage of the bile duct that moves bile from your gallbladder into your small intestine.
This can happen when either a harmless or cancerous tumor blocks your bile duct. Keep in mind that gallstones cause your gallbladder to shrink and aren’t a cause of the Courvoisier sign.
is this diagnosed?
To check for the Courvoisier sign, your doctor will start by feeling your abdomen. If they can feel your gallbladder, they’ll likely do some additional testing, even if you don’t have other symptoms, such as jaundice.
These tests include:
- Ultrasound. This provides real-time images of your gallbladder and surrounding tissues, which will help your doctor see what’s blocking your bile duct.
- CT scan. This uses X-rays from various angles to create a cross-sectional image of your gallbladder and the surrounding tissues.
- MRI. This uses magnets and radio waves to create images of the inside of the body, including the gallbladder and bile duct.
is it treated?
Courvoisier’s sign doesn’t need treatment itself. Treatment depends on the cause of the Courvoisier’s sign.
If blockage is due to a benign tumor, your doctor may perform surgery to remove the tumor and allow bile to flow again. If the tumor is cancerous, your doctor will remove the tumor before cancerous cells can spread to nearby organs.
Your doctor may use laparoscopic surgery to remove a tumor or your gallbladder, if it’s not functioning properly. To do this, your doctor will:
- give you general anesthesia
- make several small cuts in your abdomen
- insert small tools and a camera through the cuts to remove tissue or cut away your gallbladder from your liver and intestine
- close the small cuts using dissolvable stitches
If cancerous cells have spread beyond your gallbladder, your doctor may put a stent, which is a small tube, into your bile duct to let bile flow out of the gallbladder. This may be done along with other treatments that can help stop cancer from spreading, such as chemotherapy or radiation therapy to kill developing cancer cells.
Doctors often used the Courvoisier sign to rule out gallstones. If you can feel your gallbladder through your skin, but don’t feel much pain, you likely have something blocking your bile duct. Most blockages can be easily removed with noninvasive surgery.