[4] Exceptions to Courvoisier's law imply that a stone is responsible for jaundice and a non-tender, palpable gall bladder.
For example, in the case of recurrent pyogenic cholangitis complicated by calcium bilirubinate stone dislodging to the common bile duct causing a distended gallbladder by back pressure.
To reiterate, the law simply says that jaundice and non-tender, palpable gall bladders are caused by other things than chronic bile gallstone formation.
[4] Other cause includes malignancy of the CBD (i.e. cholangiocarcinoma), head of pancreas and ampulla of Vater.
[citation needed] A palpable gallbladder without mild jaundice (hence the law cannot be applied) can also be seen in Mirizzi's syndrome.