A 49-year-old man presents to the emergency department complaining that “my skin has turned yellow.” Physical examination reveals the man is significantly jaundiced. He has no abdominal pain and has a negative Murphy’s sign. The physician is concerned that he can feel the patient’s gallbladder and orders a CT scan. What is the most likely cause of this patient’s jaundice?
(A) Acute hepatitis
(B) Choledocholithiasis
© Cholelithiasis
(D) Hemolytic anemia
(E) Pancreatic cancer
Ans:
The correct answer is (E) Pancreatic cancer
This patient’s physical exam demonstrates Courvoisier’s sign: jaundice and a palpable, enlarged, nontender gall-bladder. This sign is often found in patients with cancer in the head of the pancreas, which is obstructing the gallbladder from emptying.