COURVOISIER'S LAW - CASE REPORT OF AN ATYPICAL EXCEPTION

Abstract

Abstract :
Biliary stones are usually found in the
gallbladder, but about 10-20 may spontaneously
migrate into the common bile
duct where they either remain trapped or
migrate subsequently via the papilla of
Vater into the duodenal lumen. In some
cases, biliary stones may form de novo
in the common bile duct because of local
precipitating factors. We here present a
spectacular case of huge gallstones impacted
in the common bile duct
(empierrement of the common bile duct)
that led to the development of acute
cholangitis with palpable gall bladder
(exception to Courvoisiers law). The association
of fever and rapid onset of
jaundice always makes physicians think
of cholangitis, when associated with palpable
gall bladder along with intermittent
jaundice generally periampullary carcinoma
is considered. But in our case after
investigations it turned out otherwise. After
resolution of cholangitis, stones were
secondarily removed surgically because
of the large size of the stones.
Keyword :courvoisier's law, gall bladder,
CBD calculus, cholecystectomy, choledochotomy