Courvoisier sign refers to which clinical finding?

• A. Painless Jaundice with an Enlarged Gallbladder due to Distal CBD Obstruction by an External Mass
• B. Painful Jaundice with a Small Gallbladder
• C. Fever with RUQ Pain
• D. Nausea Only

Answer: (A)

Courvoisier sign is the finding of a painless, palpable distended gallbladder in a patient with jaundice. This points to obstruction of the distal common bile duct from an external mass, most commonly a pancreatic head tumor or another malignancy. The obstruction is gradual, allowing bile to back up and enlarge the gallbladder, but without the inflammatory pain that comes with gallbladder inflammation. This differs from other scenarios: painful jaundice with a small gallbladder suggests inflammatory or infectious processes rather than malignant obstruction; fever with right upper quadrant pain aligns with cholecystitis or cholangitis; and nausea alone is nonspecific. So the best description is painless jaundice with an enlarged gallbladder due to distal CBD obstruction by an external mass.