Gall Bubble: structure, function, disease

The gallbladder is a pear-shaped or conical hollow organ that is located on the surface of the liver, between its square and right lobes. The main function of the gallbladder is the accumulation and concentration of bile, as well as its periodic "sending" through the common and bladder ducts to the duodenum.

In different people the gallbladder has different sizes, its length varies from 5 to 13-14 centimeters, width - from 2 to 4 centimeters, and the capacity is 30-70 ml. In the presence of pathological conditions, these parameters can vary significantly. In the structure of the gallbladder, the body, the bottom and the cervix are distinguished, passing into the cystic duct. The walls consist of three types of shells: muscular, mucous and connective. The lower surface of the gallbladder is covered by the serous membrane. The mucosa consists of many folds, one of which, located in the neck area and called the Geister valve, forms together with the muscle fibers the sphincter of Lutkens. In the connective tissue membrane and between the muscle fibers there are tubular channels that do not have communication with the cavity of the bladder, they are called Lushka's moves.

The liver and gallbladder are located in the right hypochondrium, but the location of the gallbladder may vary slightly, because it depends on the constitution and age. The blood supply of the gallbladder comes from the gallbladder artery, which, as a rule, departs from the right branch of the hepatic artery, the veins are multiple and form from the venous plexuses, flow into the branches of the portal vein that are inside the liver.

After eating, the gallbladder shrinks, along with it, the pressure increases, which can be 200-300 mm of water column. After that the concentrated bile enters the common bile duct. Its intensive intake is observed after consumption of egg yolks, animal and vegetable fats. Reduction of the gallbladder is replaced by relaxation and filling it with hepatic bile. The greatest intensity of this process is observed at night.

Pathological conditions and gallbladder diseases are characterized by pain in the right upper quadrant, sometimes in the epigastric region with concomitant irradiation in the collarbone, shoulder joint and right shoulder blade. Appearance and intensification of painful sensations are observed after taking of acute and fatty foods, eggs, fried foods, beer, wine, carbonated drinks, as well as after lifting weights and physical exertion, during jolting during driving and nervous-mental overstrain. However, with cholelithiasis, there may be a spontaneous, for no apparent reason, occurrence of pain. With dyskinesia of the gallbladder, a typical pain syndrome is accompanied by a vegetative crisis, the signs of which are cold sweat, numbness of the extremities, pallor of the skin, headache, etc. Very often, these diseases occur with eructations, nausea, bitterness in the mouth,

In acute inflammatory processes of the gallbladder, palpation in the right upper quadrant is very painful. Pain that increases when inhaled, is called Kehr's symptom, in sitting position - a symptom of Murphy, a pronounced soreness with a weak beating along the right costal arch - a symptom of Ortner. Symptoms of irritation of the abdominal cavity also arise in the case of development of peritonitis. In the presence of chronic inflammation of the gallbladder does not make itself felt during palpation in the right hypochondrium, as well as in painful points, and there are no symptoms of cholecystitis.

Distinguish the following malformations of the gallbladder: aplasia - its absence, hypoplasia - a decrease in its size, atresia - lack of cavity, doubling, dystopia. In addition, there are various developmental abnormalities (eg, a gallbladder with an inflection) that occur asymptomatically or with the presence of a clinical picture of cholelithiasis or chronic cholecystitis.