Anatomical location of the gallbladder. Gallbladder human anatomy

Date: 04.03.2020

Everyone needs to know the structure of the gallbladder. Near the hypochondrium on the right, spasm and painful sensations are often observed, indicating the formation of inflammation in the lower abdomen.

In humans, he plays an auxiliary role, he is not capable of producing anything by himself. Inside the bile, there is a concentration and accumulation of fluid entering through the liver cells and excretory channels.

As a result, this substance sterilizes food products, contributes to the neutralization of pancreatic juice and the breakdown of fats.

Such a formation (cholecystis) has a shape that resembles an ordinary pear, located near the lower part of the liver. She continuously produces a secret that accumulates inside.

Then it passes through the excretory tubules deep into the intestine. There, it intersects with gastric juice produced during digestive processes.

The structure of the gallbladder:

Neck... It is considered to be the narrowest area of education. The path of excretion of bile begins from it, where the accumulated secretion will be excreted into the intestines. In addition, through it, the substance enters the cholecystis itself for storage and accumulation.
Body... It has a pear-like shape or resembles a spindle, the length of which is no more than 15 cm, and the size is 75 ml. The width does not exceed 4 cm. This part is directly responsible for the accumulation and excretion of secretory fluid.
Bottom... It is not characterized by the performance of any important functions, but it is capable of being a reservoir where stones are formed.
Channel with a specific valve. Carries out a transport function, due to which bile fluid enters the body and is removed from it into the intestine.

Knowing about the anatomical structure of the considered functional unit of the human body, it is possible to accurately determine the location and cause of the pathological process, as well as to prescribe the appropriate treatment.

Zhp walls consist of 3 layers:

slimy;
muscular;
external (serous).

If you look closely, the indicated tubular formations on the outside resemble a tree, where the role of branches is played by a tract. Through it, the secret is divided into 2 ducts: right and left. During their connection, a common bile duct is formed.

Each person's anatomy has characteristic features. However, the structure of such a body assumes general parameters:

width. Approximately 3 cm.
length. Approximately 5-14 cm;
volume. More than 70 ml.

In newborns, cholecystis resembles a spindle.

Connection with other systems

The gallbladder is interconnected with other vital digestive systems. It is connected to them through the bile duct. They originate from the cholecystis itself, and then merge with the hepatic pathway into the main biliary tubular formation, which is called the choledoch.

It reaches 4 mm in diameter and connects to the duodenum, where the bile secretion enters for the subsequent enzymatic processing of food products. The liver produces a large volume of this fluid every day, but the digestive process itself does not take place around the clock.

Therefore, it is immediately consumed. Its excess is in cholecystis, which, upon a signal, begin to be excreted through the tract into the gastrointestinal tract due to an increase in its tone.

There are 4 sections of the common bile duct:

the area that is located above the duodenum;
the part behind the apex of the intestine;
the area in the middle of the head of the pancreas and the wall of the digestive tract that goes down;
distance close to the head.

Fusion with the biliary tubular system is carried out thanks to the sphincter of Oddi in the papilla of Vater. Such a specific neoplasm plays the role of a gate that regulates the penetration of secretory fluid into the duodenum.

It is covered with very dense muscles, which consist of longitudinal and circular layers. The thickening of the muscles forms the sphincter of the common bile duct. The fabrics are characterized by a smooth shape.

The blood supply is due to the gallbladder artery. It contains a blood vessel similar in function. The internal systems will be supplied with a portal vein, which carries out a circular flow of blood through the veins and in the opposite direction.

How walls work

So that a larger volume of bile secretion can fit in the specified organ, for its greater concentration, the cells begin to suck up fluid back. Therefore, it has a thicker and darker consistency than fresh, which is secreted by the liver into its own tubules.

In addition, the walls are covered with muscle tissue, which contracts, contracts and similarly pushes the secretion into the excretory canals and further into the gastrointestinal tract. The circular muscles are another layer. They form muscle tissue in the valve or sphincter, which opens and closes the outlet to the cholecystis.

The following layers are distinguished:

mucous membrane. Thinned fold, which is lined with an epithelial layer;
muscular membrane. The circular layer of smooth muscles, which passes at the end of the neck into the gate valve;
adventitia. A layer of thickened connective tissue containing elastic fibers.

Structure and localization of ducts

Knowing what the structure of the organ in question is, it is possible to establish the initial cause of the forming pathological changes.

The anatomical structure of the system that removes bile suggests 2 types of pathways:

intrahepatic... They are located in internal tissues, which are arranged in orderly rows in small tubular formations. Ready bile secretory fluid enters them directly from the cells of the gland. After isolation, it penetrates into the space of small pathways, and through the interlobar tract - into large pathways;
hepatic... Joining together, the channels form right and left pathways that drain fluid. At the transverse "bar", the tubules will unite and form the main duct.

Each of them contributes to the full functioning and proper interaction of the specified organ.

The extrahepatic biliary system includes the following components:

cystic... Connects the organs in question to each other.
basic... It starts from the junction of the exocrine gland and the bladder and goes into the intestines. A certain part of the secret begins to be excreted immediately to the biliary duct.

It is characterized by a complex network of valves that are made up of muscle tissue. The sphincter of Lutkins facilitates the passage of secretions through the canal and cervix, and the sphincter of Mirizzi connects the pathways. Below is the Oddi valve.

Usually it closes, which makes it possible for bile to accumulate in this organ. At this stage, it changes color, the number of enzymes increases by 4-5 times.

During the processing of food products, an active element is formed, with the help of which the valve will be opened, compression in the organ itself and release into digestion will occur.

Cholecystis has a specific location of the biliary tract:

the liver includes the right and left lobes. From them there is a branch into the corresponding ducts. Merging, they form a common (joint) path;
the main hepatic canal is directed towards the duodenum;
on the way to the intestine, the bile duct is poured, which leaves the cholecystis;
merged together, they form a common or joint tubular system.

Any disorders in the production and bile excretion can lead to significant disturbances in the functioning of all internal organs, pathological density of bile, urolithiasis and, as a result, the occurrence of hepatic colic and other unpleasant symptoms.

Blood supply

The supply of blood to cholecystis is carried out thanks to the artery of the bladder, starting from the hepatic vein and passing behind the main biliary tract.

It mainly gives 1 or 2 small branches for the blood flow of the cystic pathway, and then, near the walls of the organ itself, it is divided into a superficial branch, which provides blood to the proximal part of the organ itself, and a deep one, passing through the walls of the cholecystis and its bed.

Often (in fact, in 50% of patients) there are various kinds of deviations in the anatomical structure of the arteries of the bladder and liver. Often, there is a discharge of the cystic artery from the main hepatic, gastroduodenal or superior mesenteric artery.

In addition, there may be a passage of the cystic blood vessel in front of the common biliary duct, the presence of an auxiliary cystic artery (it mainly departs from the hepatic).

Less than half of the patients have a "normal" anatomical structure. The abnormal structure of cholecystis has mostly insignificant clinical significance and provides for an ectopic location, quantitative failures - the absence of the organ itself, more than 1 bladder, defects in education and development.

The standard anomaly involves a large mesentery, through which the cholecystis is attached to the liver, and in the formation of the vagus bladder, in the presence of which there is a risk of twisting.

An abnormal device is observed in half of the patients. There are multiple deviations in them, although most of the existing difficulties are interconnected either with the level or with the location of the junction between the main duct. Auxiliary pathways are extremely popular anomalies that are identified during the diagnostic process.

The cystic vein, in standard situations, originates from the hepatic artery, but sometimes it is a branch of the left, gastroduodenal or celiac trunk. The right vein departs from the mesenteric vein in about 1/5 of patients.

Organ deviations

Other abnormalities may include the main artery, which extends from the mesenteric artery.

The main canal in the upper part is supplied with blood due to the cystic vein, and from below - through the branches of the pancreatic-12 duodenal artery. Anastomoses between these branches mainly pass along the right and left edges of the common path.

When a specialist during an operation too intensively "rips off" the wall of the common biliary duct, this can provoke damage to these anastomoses, the formation of postoperative structures.

Venous blood flows from the gallbladder through the veins. They are mostly small in size, but there are a lot of them. Such blood vessels accumulate it from the interlayers of the walls and enter the external secretion gland through the bed. Further, the blood begins to outflow into the gland.

The bladder is an important link in the digestive system. He takes part in the accumulation of bile fluid for its subsequent removal to the intestines. He participates in the processing of food products, therefore it is very important to understand its structure, localization, functioning in order to timely identify the appearance of pathological changes.

When painful discomfort is felt in the hypochondrium on the right, it is necessary to seek help from a specialist - such symptoms can indicate disorders in his work.

It should be borne in mind that pain can be given from one organ to another, therefore self-treatment is prohibited. Even when the patient knows for sure about its localization, then the diagnosis should be carried out by a highly qualified doctor. This will make it possible to avoid various negative consequences and complications.

Figure 1 shows to the right of the text structure of the gallbladder... The gallbladder (GB) is a pear-shaped muscle-epithelial sac with a volume of about 30-80 cm3. It is attached by the visceral peritoneum, that is, the serous membrane (CO), to the lower surface of the liver, therefore, the upper and anterior surfaces of the body (T) of the gallbladder, with which it contacts the liver, do not have a serous membrane. These surfaces are clearly delimited by the loose connective tissue of the adventitia membrane (AO). Only the bottom (D) and the neck (W) are located intraperitoneally, that is, they are completely covered by the peritoneum. The gallbladder in Fig. 2 has been opened to reveal its internal structures.

Mucous membrane empty gallbladder is dotted with numerous folds (C). When the organ is full, they become short, flattened; the distance between them increases. The body (T) of the gallbladder continues into the neck (W), which narrows into the cystic duct (PP). The latter connects to the common hepatic duct (AKI) to form the common bile duct (CBD).

The second figure on the right shows only the fibromuscular membrane (FF) of the bladder and the probable organization of its smooth muscle bundles.

Fibromuscular membrane is divided into the outer layer (NS) of spirally oriented muscle bundles, which intersect, forming a fine-mesh structure. Part of the bundles of these fibers is separated from the spiral outer layer, forming the inner layer (BC), the fibers of which converge in the area of the bottom (D) of the gallbladder. Here the beams change direction and then go longitudinally towards the neck, where they join the outer spiral layer (for clarity, only half of the outer and inner beams are shown).

Spiral smooth muscle bundles of the gallbladder neck continue into the walls of the cystic duct (PP), where they form the muscles of the spiral Geister valve (KG)

Functions of the gallbladder is the storage and concentration of bile by water absorption.

Organ wall(picture to the left of the text) has the following layers:

consists of a single-layer prismatic epithelium (E) without goblet cells and a lamina propria (LP). The latter is formed from well-innervated and blood-supplied loose connective tissue with mucous glands only in the neck of the gallbladder. The mucous membrane is speckled with numerous elongated spiral surface primary folds (PS), which intersect with each other, and slightly deeper located secondary folds (BC) of a very diverse shape. More details about the mucous membrane in the article "Gallbladder mucosa".

Deep epithelial invaginations penetrating into the muscle layer are called diverticula (D), or Rokitansky-Ashoff's glands;

represented by a layer of irregularly oriented inner and outer smooth muscle cells, mixed with a significant amount of collagen and elastic fibers;

Cholecystokinin - a tissue hormone secreted by one of the types of enteroendocrine cells of the small intestine, stimulates the contraction of the fibromuscular membrane of the gallbladder.

- a layer of loose connective tissue of varying thickness with many blood (CS) and lymphatic (LS) vessels and nerve fibers (HB);

- the epithelium of the peritoneum, which surrounds almost the entire organ. In the area not covered by the serous membrane, the sub-serous base becomes the adventitia membrane (AO) with its loose connective tissue connecting the gallbladder with the liver.

The bile ducts are a complex transport route for hepatic secretions. They go from the reservoir (gallbladder) into the intestinal cavity.

The bile ducts are an important transport route for hepatic secretions, ensuring their outflow from the gallbladder and liver to the duodenum. They have their own special structure and physiology. Diseases can affect not only the gallbladder itself, but also the bile ducts. There are many disorders that disrupt their functioning, but modern monitoring methods can diagnose diseases and cure them.

Biliary tract is an accumulation of tubular tubules, through which bile is evacuated into the duodenum from the gallbladder. Regulation of the work of muscle fibers in the walls of the ducts occurs under the action of impulses from the nerve plexus located in the liver (right hypochondrium). The physiology of the excitation of the bile ducts is simple: when the receptors in the duodenum are irritated by food masses, the nerve cells send signals to the nerve fibers. From them to the muscle cells a contraction impulse comes, and the musculature of the biliary tract relaxes.

The movement of secretions in the bile ducts occurs under the influence of pressure exerted by the lobes of the liver - this is facilitated by the function of the sphincters, called the motor, gallbladder and tonic tension of the vessel walls. A large hepatic artery feeds the tissues of the bile ducts, and the outflow of oxygen-poor blood occurs into the portal vein system.

Bile duct anatomy

The anatomy of the biliary tract is rather confusing, because these tubular formations are small, but they gradually merge, forming large canals. Depending on how the bile capillaries will be located, they are divided into extrahepatic (hepatic, common bile and cystic duct) and intrahepatic.

The beginning of the cystic duct is located at the base of the gallbladder, which, like a reservoir, stores excess secretion, then it merges with the hepatic duct, and a common canal is formed. The cystic duct leaving the gallbladder is divided into four sections: supraduodenal, retropancreatic, retroduodenal and intramural canals. Leaving at the base of the duodenal papilla of Vater, a section of a large bile vessel forms the mouth, where the channels of the liver and pancreas are transformed into a hepato-pancreas ampulla, from which a mixed secret is released.

The hepatic canal is formed by the fusion of two lateral branches that transport bile from each part of the liver. The cystic and hepatic tubules will flow into one large vessel - the common bile duct (common bile duct).

Large duodenal papilla

Speaking about the structure of the biliary tract, one cannot but recall the small structure into which they will fall. The large papilla of the duodenum (DC) or Vater nipple is a hemispherical flattened eminence located at the edge of the fold of the mucous layer in the lower part of the DC, 10-14 cm above it is a large gastric sphincter - the pylorus.

The dimensions of the Vater nipple range from 2 mm to 1.8-1.9 cm in height and 2-3 cm in width. This structure is formed when the biliary and pancreatic excretory tracts merge (in 20% of cases, they may not join and the ducts extending from the pancreas open slightly higher).

An important element of the large duodenal papilla is, which regulates the flow of mixed secretions from bile and pancreatic juice into the intestinal cavity, and also does not allow intestinal contents to enter the bile ducts or pancreatic channels.

Pathology of the bile ducts

There are many disorders of the functioning of the biliary tract, they can occur separately, or the disease will concern the gallbladder and its ducts. The main violations include the following:

blockage of the bile ducts (gallstone disease);
dyskinesia;
cholangitis;
cholecystitis;
neoplasms (cholangiocarcinoma).

The hepatocyte secretes bile, which consists of water, dissolved bile acids, and some metabolic waste products. With the timely removal of this secret from the reservoir, everything functions normally. If there is stagnation or too fast secretion, bile acids begin to interact with minerals, bilirubin, creating deposits - stones. This problem is common in the bladder and biliary tract. Large calculi clog the lumen of the bile vessels, damaging them, causing inflammation and severe pain.

Dyskinesia is a dysfunction of the motor fibers of the bile ducts, in which there is an abrupt change in the pressure of the secretion on the walls of the vessels and the gallbladder. This condition is an independent disease (neurotic or anatomical in origin) or accompanies other disorders, such as inflammation. Dyskinesia is characterized by the appearance of pain in the right hypochondrium a few hours after eating, nausea, and sometimes vomiting.

- inflammation of the walls of the biliary tract, can be a separate disorder or a symptom of other disorders, for example, cholecystitis. The patient manifests itself as an inflammatory process with fever, chills, profuse secretion of sweat, pain in the right hypochondrium, lack of appetite, nausea.

- inflammatory process, covering the bladder and bile duct. The pathology is of infectious origin. The disease proceeds in an acute form, and if the patient does not receive timely and high-quality therapy, it becomes chronic. Sometimes, with permanent cholecystitis, it is necessary to remove the gallbladder and part of its ducts, because the pathology prevents the patient from living normally.

Neoplasms in the gallbladder and bile ducts (most often they occur in the common bile duct) are a dangerous problem, especially when it comes to malignant tumors. Drug treatment is rarely carried out, the main therapy is surgery.

Research methods of bile ducts

Methods for the diagnostic study of the biliary tract help detect functional disorders, as well as track the appearance of neoplasms on the walls of blood vessels. The main diagnostic methods include the following:

duodenal intubation;
intraoperative choledo- or cholangioscopy.

An ultrasound examination detects deposits in the gallbladder and ducts, and also indicates neoplasms in their walls.

- a method for diagnosing the composition of bile, in which the patient is parenterally injected with an irritant that stimulates contraction of the gallbladder. The method allows you to detect a deviation in the composition of the hepatic secretion, as well as the presence of infectious agents in it.

The structure of the ducts depends on the location of the lobes of the liver, the general plan resembles a branched crown of a tree, since many small vessels flow into large vessels.

The bile ducts are the transport line for the hepatic secretion from its reservoir (gallbladder) into the intestinal cavity.

There are many diseases that disrupt the functioning of the biliary tract, but modern research methods can detect the problem and cure it.

Pain on the right side of the torso may appear if the gallbladder, liver, stomach, pancreas, or intestines are out of order. The most intense pain occurs with biliary colic and is difficult to relieve. In order not to start the pathological process in the gallbladder, it is important to consult a gastroenterologist at the first painful sensations.

That is why it is necessary to know where the gallbladder is located in a person. And since pain in pathologies can radiate and be felt not only in the projection area, you need to know the function of the gallbladder in the body in order to recognize the disease by other symptoms.

Anatomy and organ location

The gallbladder is similar in shape to a pear and is located on the visceral surface of the liver in a special depression that separates the two lobes of the liver. In the anatomy of the gallbladder, three sections are distinguished: the bottom, body, neck. The bottom of the organ is located near the lower edge of the liver, and the neck is facing towards the gates of the gland and is located together with the ducts in the duplication of the hepato-duodenal ligament.

In the area where the body passes into the neck, a bend is formed, so the neck lies at an angle to the body. Between the passage to the cystic duct there is a depression called Hartmann's pocket. The norm of the size of the gallbladder in adults: length 8-14 cm, width 3-5 cm. The organ contains 60-100 ml of hepatic secretion. In children, the normal size of the organ is in an even greater range.

So, in a child 2–5 years old, the length of the gallbladder is 3–5.2 cm, width is 1.4–2.3 cm, and in a teenager, it is 3.8–8 cm long and 1.3–2.8 cm wide. If the organ is larger, then this indicates an obstruction of the bile ducts or acute cholecystitis. A decrease in size occurs with viral hepatitis (inflammation of the liver) or chronic cholecystitis. The wall of the organ includes the mucous membrane, muscular, subserous and serous layers. The mucous tissue is sensitive to adverse events in the body, which makes it look swollen and flaky.

Muscle fiber bundles are located in the longitudinal and circular directions. There are gaps between them, and then in these places the mucous tissue is connected to the serous tissue. This structure of the gallbladder increases the risk of leakage of bile into the abdominal cavity (peritonitis) without violating the integrity of the organ. There is less muscle tissue in the bottom area, and more in the neck area.

The photo shows the location of the organ relative to the liver.

The organ is supplied with blood through the cystic artery, which comes from the right branch of the hepatic artery and at the neck of the bladder is divided into two branches, one of them extends to the upper surface of the bladder, and the other to the lower one. The lymph nodes are located to the left of the bladder neck and near the duodenum. With inflammation of the bladder, the nodes enlarge and block the common bile duct.

The innervation of the biliary system comes from the celiac, lower phrenic plexuses and the anterior trunk of the vagus nerve. And this means that diseases of the stomach, small intestine or irritation of the vagus nerve (which happens with a diaphragmatic hernia) can provoke a malfunction of the sphincter of Oddi and inflammatory disorders in the bladder itself, and vice versa.

Patients often ask which side of the gallbladder. The gallbladder is located on the right side of the body, under the ribs. The liver is located in front of the gallbladder, the pylorus is on the left side, and the loops of the small intestine are on the right.

The bottom of the bladder, as a rule, extends from under the lower edge of the liver closest to the peritoneum by 2-3 cm and touches the anterior abdominal wall. This arrangement of the gallbladder and its ducts gives a projection of pain into the right hypochondrium and epigastric region.

Organ function

The function of the gallbladder in the human body is to accumulate bile, which comes continuously from the liver. Here the hepatic secretion is defended, becomes more concentrated, and then, when food enters the digestive tract, it is reflexively thrown into the duodenum.

A person can fully live without a bladder, then the question arises of why a gall bladder is needed. The fact is that the liver produces bile constantly, the secret enters the bladder through the ducts, where it lingers for several hours (until food is received). Hepatic bile is golden yellow in color, its pH is in the range of 7.3–8, and the relative density is 1.008–1.015.

In the gallbladder, bicarbonates are absorbed, which causes the pH level to drop to 6-7, and the density rises to 1.026-1.048, which means that such a secret will better fulfill its tasks: stimulate the intestines, pancreas, have a bacteriostatic effect, break down fats , promote the absorption of water-insoluble fatty acids, cholesterol, vitamins, neutralize pepsin and create conditions for the activation of pancreatic juice enzymes.

If the gallbladder does not work well, then cholecystectomy (removal) is performed. In this case, the hepatic secretion constantly enters the duodenum and, in the absence of food there, begins to affect the intestinal tissue. Since bile stimulates the secretion of pancreatic juice and gastric mucus, their production is also disrupted.

In the absence of a gallbladder, the digestion process slows down, and hence flatulence, dysbiosis, colitis, enteritis, reflux.

Features of pain syndrome

The gallbladder hurts if inflammatory or dystrophic processes occur in it. Most often, pathological processes develop as a result of blockage of the biliary tract by calculus or due to dyskinesia. Because the gallbladder hurts, pathology can be assumed. Against the background of pathological conditions, biliary (hepatic) colic occurs, which is characterized by severe pain.

With biliary colic, pain often appears against a background of complete calmness. It is felt on the right under the ribs in the area of the gallbladder projection, less often in the upper abdomen.

Characterized by the spread of pain to the area of the right scapula, clavicle, neck, shoulder. In some situations, pain is felt in the region of the heart and the person thinks that this is an attack of angina pectoris. The pain is described as cutting, stabbing, tearing.

An attack of hepatic colic is usually accompanied by nausea, vomiting of bile (it is not abundant and does not bring relief), flatulence. Palpation reveals muscle tension in the anterior abdominal wall. If vomiting persists, then this indicates the involvement of the pancreas in the pathological process.

Soreness with damage to the biliary tract lasts from a quarter of an hour to 60 minutes

If the pain persists longer, then this is a sign of complication. This is also indicated by an increase in temperature above 38 0 C. As a rule, colic occurs after eating spicy, fatty, heavy foods. Colic does not appear out of nowhere, patients indicate that there were previously pains in the right hypochondrium of varying duration and intensity. As the pathology develops, episodes of biliary colic become more frequent and their intensity increases.

Cholecystitis

With chronic or acute cholecystitis, constant aching or sharp pains in the gallbladder region are felt. The pain can radiate to the right shoulder blade, shoulder, neck, less often the pain syndrome spreads to the left half of the body. Biliary colic, as a rule, appears after drinking alcohol, fatty or spicy foods, severe stress.

Sometimes patients complain of a metallic taste or bitterness in the mouth, belching, flatulence, nausea, stool disturbance, insomnia or irritability, low-grade fever. Acute cholecystitis with mild course can proceed quickly (5-10 days) and end with recovery. If an infectious agent has entered the body, then the disease can turn into purulent cholecystitis. It is dangerous and can have non-specific manifestations.

Pain syndrome with purulent cholecystitis is very pronounced, is determined in the right half of the abdomen, but can spread to the right shoulder blade, shoulder.

During the episode, the patient assumes a forced position of the body ("fetal position"), turns pale, sweats a lot. In addition, the body temperature rises, chills, tachycardia occur. Usually, with the disease, other symptoms appear that indicate damage to the abdominal cavity (flatulence, nausea, vomiting of bile, heaviness in the abdomen).

Since the organs of the human digestive system are interconnected, inflammation from one of them often passes to others. For example, cholecystitis can cause the development of pancreatitis and gastritis, and vice versa. The fact is that the ducts from the pancreas and the biliary system open into the duodenum and in case of disorders, pancreatic juice can penetrate into the bladder, which causes a strong inflammatory reaction.

With inflammation of the gallbladder, the biliary function is impaired.

Cholelithiasis

The stones can be cholesterol, calcium or bilirubin. Cholesterol is in a bound state, but if there are not enough binding bile acids, then it precipitates. At first, small stones form, but gradually they increase, and under certain conditions they can block the bile ducts.

In this case, bile does not penetrate into the duodenum, the pressure in the bladder begins to grow, stones injure the mucous membrane, and therefore the gallbladder hurts. In developed countries, gallstone disease is diagnosed in a third of women and a quarter of men. The symptomatology of gallstone disease depends on the location of the stones and their size.

So, if the stone is at the bottom or in the area of the body of the organ and there is no inflammation, then there is no pain. If the stone is close to the neck, then moderate pain occurs. If the calculus has reached the ducts, then a strong attack appears, since the outflow of bile is disturbed, spasm and ischemia of the wall occurs. The sections of the ducts that are higher, when the stone moves, are strongly stretched, which causes an increase in peristalsis, so the pain does not stop until the stone reaches the intestines.

With gallstones, biliary colic occurs, which is characterized by severe acute, sudden pain under the right rib. The nature of the pain is cutting or stabbing. After a few hours, the pain is concentrated in the area of the projection of the gallbladder. The cause of the pain is a spasm of the muscles of the gallbladder.

With a complete blockage of the bile duct, the liver ducts expand, the organ enlarges, which causes a painful reaction in the overstretched capsule. Such pain has a constant dull character and is often accompanied by a feeling of heaviness in the right hypochondrium.

Biliary dyskinesia

In pathology, the motility of the organ is disrupted, which is why the hepatic secretion stagnates. In some cases, dyskinesia occurs as a result of spasm of the smooth muscles of the bladder. The disease can be primary, that is, independent (as a result of hormonal imbalance, stress), or secondary, developing against the background of chronic diseases of the gastrointestinal tract.

With hypertensive dyskinesia, the main symptom is acute colicky pain under the ribs on the right, which radiates to the right shoulder blade or shoulder. Pain occurs after a violation of diet, physical activity, in a stressful situation. Additional symptoms are nausea, vomiting, stool disorder, and polyuria.

The pain can go away on its own or quickly stop with drugs that relieve spasm. In the absence of an attack, the patient's well-being is satisfactory, spastic pains periodically appear in the right hypochondrium, in the upper abdomen or near the navel, but they quickly pass.

With hypokinetic dyskinesia, there is a constant, not strong, dull or aching pain in the right hypochondrium, and a feeling of heaviness and stretching in this area is also noted. After strong experiences or eating, dyspeptic disorders appear: bitterness in the mouth, belching, nausea, flatulence, stool disturbance, loss of appetite.

On palpation in the area where the gallbladder is located, the pain is moderate

When a pathology occurs in the gallbladder or biliary tract, a digestive upset necessarily appears, since what the gallbladder is responsible for, namely, fast and high-quality digestion of food, is impossible. Therefore, stool disturbance, bloating, nausea, vomiting can be attributed to the clinical manifestations of cholecystitis.

If pain appears in the right hypochondrium, then a comprehensive diagnosis is required. Normally, the size of the gallbladder can vary in different people, therefore, during palpation, pain and tension of the abdominal wall are more important. During ultrasound examination, it is noticeable that the wall of the gallbladder is thickened (more than 4 mm), with a double contour.

On X-rays, calculi are clearly visible, and with the help of contrast, you can see how the organ contracts. Blood counts allow you to assess the level of inflammation, to determine if there is a violation in the work of the pancreas. If pathological processes occur in the organ, and it does not perform what the gallbladder is needed for, then doctors recommend cholecystectomy.

Only by removing the organ can the spread of inflammation throughout the hepatobiliary and digestive systems be avoided. The role of the gallbladder in the human body is essential, but after the operation, the digestive tract adapts and is able to function normally.

Functions of the gallbladder

Dyskinesia of the gallbladder

Cholecystitis

Cholelithiasis

Gallbladder cancer

How to heal the gallbladder

The gallbladder is the organ that stores bile from the liver. It is located in the right longitudinal furrow and has a characteristic green color. The size of a liver is the size of a chicken egg. Several times a day, bile is secreted into the duodenum and is directly involved in the digestive process. Anatomically, the gallbladder is a continuation of the liver. Therefore, any diseases of one of the organs in one way or another negatively affect the state of the other.

Features of the structure of the gallbladder

The external gallbladder resembles a saccular oval formation of an elongated shape with one wide and the other narrow end. The width of the organ decreases from the bottom to the neck, where the cystic bile duct begins to pass. At the gate of the liver, it enters the hepatic duct, and together with it forms the common bile duct, which is combined with the pancreatic duct. Through the sphincter of Oddi, it passes into the duodenum.

The length of the gallbladder in adults reaches 8-10 cm. The width of the walls of the organ is 3-5 cm, but it can change due to stagnation of bile, overstretching of the walls with calculi and the action of a chronic inflammatory process.

Functions of the gallbladder

The main functions of the gallbladder:

accumulation and concentration of bile;
participation in the digestive process;
protection of the digestive tract from infectious pathogens;
timely entry of the required amount of bile into the duodenum.

The liver continually secretes bile and it is stored in the gallbladder. When food enters the stomach, complex biochemical processes are triggered. The gallbladder contracts and releases a portion of bile into the duodenum, where it begins to directly participate in the digestive process. With increased fat content of foods, the organ begins to shrink more intensively in order to secrete more secretions.

Bile contains special pigments, acids, phospholipids, trace elements and substances with antimicrobial activity. It is the protective function of the gallbladder that prevents the appearance of infectious and inflammatory processes in other organs of the digestive system.

Causes of gallbladder disease

The gallbladder is constantly influenced by external and internal factors, including the nature of a person's diet, stress, concomitant diseases, and the level of physical activity. And for a long time, a person may not be aware of the pathology. The main reason for the development of most diseases of the gallbladder is the formation of calculi.

Stones cause an inflammatory process, provoke stagnation of bile, the multiplication of infectious pathogens, blockage of ducts, the development of dangerous diseases that require, among other things, surgical treatment.

Factors provoking dysfunction of the gallbladder and the development of diseases:

Diseases of the gallbladder are characterized by a long, asymptomatic course. And only years later, characteristic signs may appear that speak of stagnation of bile and blockage of the bile ducts with stones.

Symptoms of dysfunction of the gallbladder

The main symptom of gallbladder diseases is acute or dull aching pain in the right hypochondrium. It occurs with calculous cholecystitis, and with non-calculous cholecystitis, and with the formation of cysts and tumors. Depending on the intensity of the pain syndrome, a person decides whether to seek professional help or not. But there is no need to wait for signs of acute biliary colic, which can result in serious complications, including perforation of the bladder walls. As soon as pain appears in the right hypochondrium, make an appointment with a gastroenterologist or therapist and go through a set of laboratory and instrumental studies.

Additional symptoms of gallbladder disease:

nausea and vomiting;
belching with bitterness;
violation of the stool, but more often - diarrhea, discoloration of feces;
bloating;
darkening of urine;
small rashes on the body.

Signs of biliary colic

Before the onset of symptoms of biliary colic, many do not even know about the presence of calculi. A person has acute pain in the right hypochondrium and epigastrium, which can radiate under the scapula, in the neck and lower back. Fatty or spicy foods, alcohol consumption provoke the appearance of attacks.

Some people develop biliary colic after excessive physical exertion and severe stress. If a stone gets stuck in the bile duct, obstructive jaundice appears, feces become discolored, and urine darkens.

Common diseases of the gallbladder

There are many diseases of the gallbladder, but the most common are the following:

dyskinesia of the gallbladder;
cholecystitis;
cholelithiasis;
gallbladder cancer.

Dyskinesia of the gallbladder

With dyskinesia of the gallbladder, the contractility of the organ is disrupted and the outflow of bile worsens. The disease progresses more often in women. Primary dyskinesia occurs with congenital impairment of the motor activity of the gallbladder and a decrease in the sensitivity of its cells to hormonal mediators. Secondary dyskinesia is the result of hormonal treatment, the development of concomitant diseases and pathology of the biliary tract, including gallstone disease and cholecystitis.

Most often, the disease develops due to high pressure in the biliary tract in combination with a reduced activity of the bladder walls. In this case, the organ is not emptied on time, bile in a limited amount enters the duodenum, which provokes chronic digestive disorders.

The main symptoms of gallbladder dyskinesia:

constant dull pain in the right hypochondrium, not associated with food intake;
pain syndrome increases with a change in body position, when intra-abdominal pressure rises and bile outflow worsens;
nausea and vomiting;
slight yellow staining of the skin;
a feeling of bitterness in the mouth;
increased sweating;
the appearance of a saturated color of urine.

For the treatment of gallbladder dyskinesia, prokinetics, antispasmodics, nonsteroidal anti-inflammatory drugs are used. Prescription of bile-containing drugs is possible. The main focus is on diet. It is worth limiting foods that excessively constrict the gallbladder: fats, fried, smoked and spicy foods, alcohol. Additionally, it is recommended to normalize weight and give up excessive physical exertion.

Cholecystitis

Cholecystitis is an inflammation of the gallbladder, which occurs most often against the background of calculus formation. The disease occurs in middle-aged and elderly people, mainly in women.

Violation of the outflow of bile provoke diseases such as gallstone disease, biliary dyskinesia, congenital or acquired anomalies in the development of the gallbladder. Violation of the diet, frequent alcohol consumption, a sedentary lifestyle, and large intervals between meals predispose to the development of cholecystitis.

The main symptoms of the inflammatory process in the gallbladder:

paroxysmal pain in the right hypochondrium and abdomen;
weakness;
excessive sweating;
nausea, vomiting mixed with bile;
diarrhea;
pronounced flatulence;
a feeling of bitterness in the mouth;
chills, slight increase in body temperature;
yellowness and itching of the skin.

Like other diseases of the gallbladder, cholecystitis requires a diet. Food should be as gentle as possible on the mucous membrane of the digestive tract. It is recommended to eat 5-6 times a day, but in small portions. Prohibited alcohol in any form, fatty meats and fish, smoked meats, seasonings, marinades, spices, sauces, mushrooms, legumes.

Drug therapy includes the appointment of pain relievers and antispasmodics. With the infectious nature of cholecystitis, antibiotics are prescribed. In addition, experts recommend using drugs that stimulate bile formation (choleretics) or accelerate the outflow of bile (cholekinetics). But such remedies are prescribed only by a doctor who knows the nature of the disease and the state of the gallbladder.

With calculous form of cholecystitis, surgical treatment is used - open or laparoscopic cholecystectomy.

Cholelithiasis

Gallstone disease is accompanied by the formation of calculi in the gallbladder and ducts. The pathology is based on the deposition of pigments, proteins, calcium salts as a result of lipid metabolism disorders and constant stagnation of bile.

The experience of specialists has shown that drug therapy for calculous cholecystitis and other complications of gallstone disease is ineffective. The only correct decision is the timely execution of the operation. Otherwise, dangerous complications may appear, including perforation of the gallbladder wall.

The main symptoms of gallstone disease:

sharp cutting pain in the right hypochondrium, which appears after consuming prohibited foods and drinks;
nausea and vomiting (occur reflexively in response to irritation of the peri-papillary zone of the duodenum);
vomit may contain traces of bile;
increased body temperature;
with blockage of the sphincter of Oddi and the common bile duct, obstructive jaundice occurs, feces become discolored, urine may darken.

Pain syndrome with gallstone disease occurs as a result of spasm of the muscles of the gallbladder and its ducts in response to the irritating effect of calculi and overstretching of the walls of the organ. With an exacerbation, a person needs immediate medical attention.

Medical treatment of gallstones is ineffective. It only allows you to slow down the development of the disease. Even after the destruction of calculi during shock wave lithotripsy or laparoscopy, the risk of their recurrence is very high. Therefore, experts recommend carrying out cholecystectomy before complications and severe disturbances in the work of the digestive system appear.

Watch this video about one of the common gallbladder diseases in which calculus forms.

Gallbladder cancer

In the gallbladder, malignant tumors can appear - adenocarcinoma or squamous cell neoplasms. They account for 5-10% of all cancerous diseases of the gastrointestinal tract. The tumor process is more often found in women after 50 years. In 80% of cases, experts identify adenocarcinoma, which can grow in the bottom or in the neck of the gallbladder. Cancer often metastases to regional lymph nodes, peritoneum, ovaries, and liver.

The main cause of a malignant tumor of the gallbladder is a long course of gallstone disease or chronic cholecystitis. Most often, a tumor develops in an organ clogged with stones. Concrements permanently damage the mucous membrane of the gallbladder, provoking malignant degeneration of tissues.

The main symptoms of gallbladder cancer are:

weakness;
constant dull pain in the hypochondrium, which people with gallstone disease get used to ignore;
weight loss;
subfebrile temperature;
yellowing of the skin and mucous membranes;
constant nausea, vomiting may occur;
itchy skin;
clarification of feces and darkening of urine.

For a long time, gallbladder cancer proceeds without pronounced symptoms. Often, the disease is discovered by chance during histology with cholecystectomy or against the background of calculous cholecystitis.

With early treatment for medical care and an open cholecystectomy, the prognosis of the disease is favorable. But the disease in most cases is detected at a late stage, when distant metastases are actively spreading and it is impossible to do only with a radical removal of the neoplasm.

How to heal the gallbladder

Treatment of the gallbladder is selected by a gastroenterologist or therapist based on laboratory and instrumental diagnostics data. In this case, the age of the patient is taken into account. As a rule, most of the pathologies of the gallbladder are based on a chronic inflammatory process against the background of cholelithiasis. Therefore, the main method of treatment is the removal of stones or the affected organ.

At an intermediate stage, during preparation for surgery or when providing first aid to a person with symptoms of biliary colic, the following groups of funds may be prescribed:

antispasmodics, analgesics;
anti-inflammatory drugs;
choleretic drugs, choleretics and cholekinetics;
hepatoprotectors;
multivitamin complexes;
preparations with acids that can have a destructive effect on calculi.

Treatment of the gallbladder necessarily includes adherence to a therapeutic diet (table number 5). The number of exacerbations of the underlying disease per year largely depends on this. If a doctor recommends an operation, you should not refuse it. Specialists are aware of severe cases of complications, due to which people end up in intensive care, and the surgeon still has to urgently perform cholecystectomy.

Indications for surgical treatment

Gallstone disease and chronic cholecystitis are accompanied not only by the formation of calculi, but also by irreversible impairment of the functional abilities of the gallbladder. The organ ceases to perform its main work, and there is no point in preserving it, since impaired functions can trigger a chain of additional diseases of the gastrointestinal tract.

The main indication for cholecystectomy is the presence of calculi. The operation can be carried out as planned and urgently, be open (with a dissection of the anterior abdominal wall) or laparoscopic (the surgeon removes the organ through 4 punctures). Laparoscopy of the gallbladder is preferable to laparotomy. The operation with the help of microsurgical instruments and endoscopic equipment is easier to perceive, moreover, it does not require a long recovery.

On an emergency basis, open cholecystectomy can be performed if there is a threat of dangerous complications, including peritonitis and the risk of perforation of the walls of the gallbladder.

Nutrition for gallbladder health

Diseases of the gallbladder are chronic. The process of bile secretion is influenced by the degree of fat content of foods and many other features of food. With pathologies of the gallbladder, it is very harmful to eat rarely, making large gaps between meals. In this case, bile constantly stagnates, irritates the walls and creates conditions for the formation of stones.

It is recommended to eat at regular intervals, preferably at the same time. All potentially dangerous and prohibited foods, alcohol, carbonated drinks, sour juices must be excluded from the diet. The diet should be especially strict during an exacerbation of the disease. On the first day after the development of biliary colic, it is forbidden to eat, and you can drink only a decoction of chamomile, rose hips or non-carbonated mineral water.

Prevention of gallbladder disease

Even if you don't have gallbladder disease, you can reduce your risk by following healthy eating principles. Limit spicy, fatty, spicy foods, sauces and mayonnaise, smoked meats. Do not consume fast food, alcohol, try to exercise regularly and lead an active lifestyle.

Prevention of the appearance of diseases of the gallbladder necessarily includes preventive examinations of the organ, especially with unfavorable heredity. If among your close relatives there are people who suffer from cholecystitis or gallstone disease, do not be lazy to regularly undergo ultrasound diagnostics. And if stones are found, agree to surgical treatment.

Watch talks about the gallbladder with Professor Neumyvakin.