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Which of the following statement(s) is/are correct regarding Courvoisier's law?I. Chronic cholecystitis is generally associated with an enlarged, palpable gallbladderII. In the presence of jaundice, a palpable gallbladder should alert the examiner of the possibility of biliary obstruction secondary to carcinoma of the head of the pancreasIII. Biliary obstruction secondary to gallstones is generally associated with a (non-enlarged) fibrotic gallbladder from coexisting chronic cholecystitisIV. Billary obstruction secondary to carcinoma of the head of the pancreas will generally not result in jaundice

Question

Which of the following statement(s) is/are correct regarding Courvoisier's law?I. Chronic cholecystitis is generally associated with an enlarged, palpable gallbladderII. In the presence of jaundice, a palpable gallbladder should alert the examiner of the possibility of biliary obstruction secondary to carcinoma of the head of the pancreasIII. Biliary obstruction secondary to gallstones is generally associated with a (non-enlarged) fibrotic gallbladder from coexisting chronic cholecystitisIV. Billary obstruction secondary to carcinoma of the head of the pancreas will generally not result in jaundice

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Solution

The correct statements regarding Courvoisier's law are:

I. False - Chronic cholecystitis is generally associated with a shrunken, fibrotic gallbladder, not an enlarged, palpable one.

II. True - Courvoisier's law states that in the presence of jaundice, a palpable gallbladder should alert the examiner of the possibility of biliary obstruction secondary to carcinoma of the head of the pancreas.

III. True - Biliary obstruction secondary to gallstones is generally associated with a (non-enlarged) fibrotic gallbladder from coexisting chronic cholecystitis.

IV. False - Biliary obstruction secondary to carcinoma of the head of the pancreas will generally result in jaundice, not the other way around.

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