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Courvoisier's sign occurs due to the gradual (chronic) nature of the obstruction caused by cancer (e.g. pancreatic, often located in pancreatic head, cholangiocarcinoma, etc.), which gradually causes biliary back-pressure and gradually distends the gallbladder over time, without causing acute damage, thus without causing pain.
Gallbladder cancer is a relatively uncommon cancer, with an incidence of fewer than 2 cases per 100,000 people per year in the United States. [7] It is particularly common in central and South America, central and eastern Europe, Japan and northern India; it is also common in certain ethnic groups e.g. Native American Indians and Hispanics. [8]
Gallbladder diseases are diseases involving the gallbladder and is closely linked to biliary disease, with the most common cause being gallstones (cholelithiasis). [1] [2]The gallbladder is designed to aid in the digestion of fats by concentrating and storing the bile made in the liver and transferring it through the biliary tract to the digestive system through bile ducts that connect the ...
Gallbladder hepatization, which is biliary sludge filling the entire gallbladder, giving it an echogenicity similar to the liver (seen at left). The patient had a stone in the cystic duct. Biliary sludge is typically diagnosed by CT scan or transabdominal ultrasonography. [1] [2] Endoscopic ultrasonography is another more sensitive option.
A Klatskin tumor (or hilar cholangiocarcinoma) is a cholangiocarcinoma (cancer of the biliary tree) occurring at the confluence of the right and left hepatic bile ducts. The disease was named after Gerald Klatskin, who in 1965 described 15 cases and found some characteristics for this type of cholangiocarcinoma. [1] [2] [3]
Other biliary tract cancers include gallbladder cancer and cancer of the ampulla of Vater. [7] Risk factors for cholangiocarcinoma include primary sclerosing cholangitis (an inflammatory disease of the bile ducts), ulcerative colitis, cirrhosis, hepatitis C, hepatitis B, infection with certain liver flukes, and some congenital liver malformations.
Patients with cholelithiasis typically present with pain in the right-upper quadrant of the abdomen with the associated symptoms of nausea and vomiting, especially after a fatty meal. The physician can confirm the diagnosis of cholelithiasis with an abdominal ultrasound that shows the ultrasonic shadows of the stones in the gallbladder .
PSC increases the risk of various cancers, including liver cancer, gallbladder carcinoma, colorectal cancer, and cholangiocarcinoma. [1] [2] The underlying cause of PSC is unknown. Genetic susceptibility, immune system dysfunction, and abnormal composition of the gut flora may play a role.