This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Gall Bladder & Bile Ducts, Subject name: Surgery
Courvoiser's law exception is 
Select and explain. 
A. Double impaction, B. Portal lymphadenopathy, C. Periampullary CA, D. None
A: Double impaction
Answer: A: Double impaction 
Explanation: Ans. (a) Double impactionRef: Long cases in Surgery RRMAs per law" In obstructive jaundice if GB is palpable it is due to Cancer and if not, palpable it is due to stones"Exceptions to Courvoisier law:* Double impaction of stone- One at Cystic Duct and another at CBD (Where GB is palpable)* Hilar Cholangiocarcinoma (Where GB is not palpable)