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학습 자료 둘러보기 →The classic triad for malignant obstruction is painless jaundice, clay-colored stools, and dark urine. This occurs when a tumor in the head of the pancreas compresses the common bile duct.
Pathophysiology: The blockage prevents conjugated bilirubin from reaching the gut. Bilirubin backs up into the blood (jaundice) and is excreted by the kidneys (dark urine). The absence of bilirubin in the intestines prevents the formation of stercobilin, leading to clay-colored stools.
Painless jaundice is a hallmark but not an absolute rule. Some patients may report dull epigastric pain. A palpable, non-tender gallbladder (Courvoisier sign) strongly supports a malignant cause. Do not confuse this with the colicky pain of gallstones.
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