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Palpation of Gallbladder

Normally gallbladder is not palpable. When it is enlarged it is felt as a firm smooth globular swelling with distinct borders just lateral to the edge of the Right rectus near the tip of the 9th costal cartilage. It moves well with respiration.
Causes of palpable gallbladder
Enlarged gall bladder with jaundice
Carcinoma triad
  • Carcinoma head of pancreas
  • Carcinoma Ampulla of Vater
  • Carcinoma bile duct
Enlarged gallbladder without jaundice
  • Mucocoele of gallbladder
  • Cystic duct obstruction by stone
  • Carcinoma of gallbladder- Gallbladder is felt as a stony hard, irregular swelling.
Courvoisier’s Law
  • In cholelithiasis, the gallbladder is thickened, contracted and not palpable due to repeated cholecystitis. Gallbladder is distended and palpable in Ca head of pancreas.
Murphy’s Sign
Ask the patient to breath deeply and palpate for gallbladder, at the height of inspiration, breath is arrested with pain in acute cholecystitis,It is called Murphy's sign.