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What is Courvoisier syndrome?

Courvoisier syndrome is also called Courvoisier's law or Courvoisier's sign. It means that you have jaundice and a gallbladder that is enlarged but is not painful.

Your doctor can feel an enlarged gallbladder when they examine you. The gallbladder is a small pouch by the liver. It fills with bile, a yellowish liquid which helps to digest fats.

Diagram showing the position of the gallbladder and bile ducts

The gallbladder releases bile into the intestine after a meal. But if the flow of bile from the gallbladder is blocked, the body tissues absorb the yellowish pigments in bile instead. This causes jaundice. Jaundice is a yellowing of the skin and whites of the eyes.

Causes of Courvoisier syndrome

These symptoms usually mean there is a blockage in the digestive system just below where the bile duct (the tube from the gallbladder) joins the intestine. Most blockages affecting the gallbladder are caused by gallstones.

The fact that there is no pain in Courvoisier syndrome suggests that gallstones probably aren’t the cause of the jaundice. The gallbladders of people who have gallstones can also be shrunken due to repeated infections, so the doctor is less likely to feel them.

Your doctor might suspect that this blockage is caused by cancer and will want to do some tests, such as a scan and taking samples of body tissue from the area (a biopsy). The types of cancer most likely to block the bile duct are pancreatic cancer and gallbladder cancer.

Treatment for Courvoisier syndrome

If the cancer can be removed with surgery, it can sometimes be cured and can allow the bile to flow again.

Advanced cancers can't be removed but your doctor might suggest putting in a small tube called a stent to allow the bile to drain away. This relieves the jaundice. They might also suggest treatment with chemotherapy or radiotherapy to try to shrink the cancer for a while. This treatment doesn't work for everyone but new treatments are always being tried.

Last reviewed: 
23 Jun 2017
  • Courvoisier's gallbladder: law or sign?
    JE Fitzgerald and others
    World Journal of Surgery, 2009 Apr;33(4): pages 886-91

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