PAEA Surgery End Of Rotation (EOR) Practice Exam

What is Courvoisier's gallbladder associated with?

1. Cirrhosis

2. Cholecystitis

3. Pancreatic cancer

4. Hepatocellular carcinoma

The correct answer is: Pancreatic cancer

Courvoisier's gallbladder refers to the enlargement of the gallbladder, which is typically associated with obstruction of the bile duct. When a tumor, such as one arising from pancreatic cancer, obstructs the common bile duct, it prevents bile from draining properly, leading to gallbladder distension. The presence of a palpable gallbladder in a patient with jaundice is considered highly suggestive of a mass obstructing the biliary tree, with pancreatic cancer being a common culprit. This association is significant because Courvoisier's gallbladder can help in differentiating between obstructive causes of jaundice. In the context of pancreatic cancer, the tumor may be located at the head of the pancreas, causing compression of the bile ducts. Understanding this relationship aids in the clinical evaluation of a patient with biliary tract obstruction and can guide further imaging and diagnostic efforts. Other conditions such as cirrhosis, cholecystitis, and hepatocellular carcinoma can lead to biliary issues, but they do not typically result in the distinct pattern of gallbladder enlargement as seen in Courvoisier's gallbladder secondary to bile duct obstruction from pancreatic malignancies.