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A 45-year-old woman presents with a 2-week history of painless jaundice, dark urine, and pale stools. She has lost 5 kg in weight. On examination, a palpable, non-tender gallbladder is noted. Her bilirubin is 180 µmol/L (conjugated > unconjugated).
What is the most likely diagnosis?
What is the most likely diagnosis?
is the key mechanism of action.
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This presentation is classic for Courvoisier's law — painless obstructive jaundice with a palpable gallbladder in the absence of gallstones suggests malignant obstruction, most commonly pancreatic head carcinoma. The triad of painless jaundice, weight loss, and palpable gallbladder is highly suggestive. CT abdomen with pancreatic protocol is the investigation of choice.
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