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

What is jaundice?

Jaundice is a yellowing of the skin and whites of the eyes.

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. 

Causes of Courvoisier syndrome

The symptoms of jaundice and an enlarged gallbladder usually mean there is a blockage in the digestive system just below where the bile duct Open a glossary item 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 may often shrink. This might be due to repeated infections, so the doctor is less likely to feel them.

The types of cancer most likely to block the bile duct are pancreatic cancer and bile duct cancer.

Courvoisier syndrome can also be caused by other conditions, such as long term inflammation of the pancreas.

Tests and scans

Your doctor might suspect that the blockage is caused by cancer and will want to do some tests. For example, blood tests. They will also ask questions about other symptoms you may have and how long you’ve had them, and examine you. 

Other tests and scans you might have include:

  • an ultrasound scan
  • a CT scan
  • a type of MRI scan called MRCP- which stands for magnetic resonance cholangio pancreatography
  • a biopsy Open a glossary item

Your doctor will explain what tests you need and why you need them. 

We have information on the different tests and scans you might have to find out if you have cancer.

Treatment for Courvoisier syndrome

Treatment depends on the cause of the blockage. 

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

Advanced cancers Open a glossary item can not be removed. But your doctor might suggest putting in a small tube called a stent to allow the bile to drain away. This can relieve the jaundice.

They might also suggest treatment with chemotherapy or radiotherapy. This is to try to shrink the cancer for a while. This treatment doesn't work for everyone, but new treatments are always being tried.

Coping with cancer

Coping with cancer can be difficult. There is help and support available. We have information about coping with a cancer diagnosis. And information for your family and friends.

  • Extrahepatic biliary obstruction secondary to metastatic esophageal squamous cell carcinoma: An unusual presentation of Courvoisier's law

    K Atiba and others

    Clinical Case reports, 2021.

  • Simultaneous Courvoisier's and double duct signs

    S Agrawal and S Vohra

    World Journal of Gastrointestinal Endoscopy, 2017. Volume 9, Issue 8, Pages 425-427.

  • The Courvoisier’s sign
    D Giambelluca1 and others 
    Abdominal Radiology, 2019, Volume 44, Pages 1185–1186

  •  Management of jaundice in adults
    The National Institute for Health and Care Excellence (NICE) revised in November 2020 (accessed October 2023)

Last reviewed: 
09 Oct 2023
Next review due: 
09 Oct 2026

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