A 45-year-old man presents with painless jaundice, dark urine, pale stools, and weight loss. On exam, his gallbladder is palpable but non-tender.
What is the most likely diagnosis?
A) Acute cholecystitis
B) Chronic hepatitis
C) Pancreatic head carcinoma
D) Gilbert’s syndrome
Hint: Courvoisier’s sign is positive.
Pancreatic head carcinoma
Most likely diagnosis will be Pancreatic head carcinoma
Because a positive courvoisier sign - palbable , non - tender , enlarged fall bladder with painless jaundice - suggest a obstruction to bile duct mostly due to a gradual pressure build from a tumour
Incase of acute cholecystitis -obstruction to cystic duct mostly due to gall stones and the patient presents with severe abdominal pain - Murphy’s sign positive - which is not indicated in this patient condition
Chronic hepatitis - may some time cause gall stones induced gall bladder disease - cholecystitis,but patient will present with abdominal pain and Murphy sign positive
Gilbert syndeome- an autosomal recessive disease of liver ,in which the patient presents with increased levels of indirect bilirubin ( unconjugated hyperbilurubinemia)