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Courvoisier's principle (known as Courvoisier's sign or Courvoisier–Terrier's sign, or Courvoisier syndrome) states that a painless palpably enlarged gallbladder accompanied with mild jaundice is unlikely to be caused by gallstones. Usually, the term is used to describe the physical examination finding of the right-upper quadrant of the abdomen.
Jaundice, also known as icterus, is a yellowish or greenish pigmentation of the skin and sclera due to high bilirubin levels. [3] [6] Jaundice in adults is typically a sign indicating the presence of underlying diseases involving abnormal heme metabolism, liver dysfunction, or biliary-tract obstruction. [7]
Gallstones are more common in pregnant women due to elevated hormones and cholesterol levels, which block the bile duct and obstruct bilirubin excretion. [11] Besides, preeclampsia and eclampsia , denoted by high blood pressure , are linked to hyperbilirubinemia through damaging highly perfused organs , particularly liver and kidneys . [ 12 ]
It presents with painless jaundice which may have a waxing and waning nature, because at times the sloughing of the tumor tissue relieves the obstruction partially. [citation needed] Signs and symptoms of periampullary cancer [2] Jaundice (yellowing of skin, eyes and urine with pale stools) Itching; Abdominal pain; Weight loss and loss of appetite
Two-thirds of patients present with either painless jaundice due to bile duct obstruction or a "mass" in the head of the pancreas, mimicking carcinoma. As such, a thorough evaluation to rule out cancer is important in cases of suspected AIP. [4] Type 1 AIP typically presents in a 60–70-year-old male with painless jaundice.
The most common findings are fever (usually sustained, but with temperature no greater than 102 °F or 39 °C), pale appearance, malaise, painless liver enlargement, jaundice, enlarged lymph nodes, and enlarged spleen. This phase is characterized by severe hemolytic anemia and transient immunosuppression.
Jaundice of the skin or eyes is an important physical finding in biliary obstruction. Jaundice and/or clay-colored stool may raise suspicion of choledocholithiasis or even gallstone pancreatitis. [1] If the above symptoms coincide with fever and chills, the diagnosis of ascending cholangitis may also be considered.
Some may report jaundice (yellow discoloration of the skin and the whites of the eyes). [1] Physical examination findings typically include jaundice and right upper quadrant tenderness. [1] Charcot's triad is a set of three common findings in cholangitis: abdominal pain, jaundice, and fever. [4]