Where is gallbladder located picture: Picture, Definition, Problems, Tests & Function
Picture, Definition, Problems, Tests & Function
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Front View of the Gallbladder
The gallbladder is a small pouch that sits just under the liver. The gallbladder stores bile produced by the liver. After meals, the gallbladder is empty and flat, like a deflated balloon. Before a meal, the gallbladder may be full of bile and about the size of a small pear.
In response to signals, the gallbladder squeezes stored bile into the small intestine through a series of tubes called ducts. Bile helps digest fats, but the gallbladder itself is not essential. Removing the gallbladder in an otherwise healthy individual typically causes no observable problems with health or digestion yet there may be a small risk of diarrhea and fat malabsorption.
Get more information from WebMD videos on gallbladder basics.
- Gallstones (cholelithiasis): For unclear reasons, substances in bile can crystallize in the gallbladder, forming gallstones. Common and usually harmless, gallstones can sometimes cause pain, nausea, or inflammation.
- Cholecystitis: Infection of the gallbladder, often due to a gallstone in the gallbladder. Cholecystitis causes severe pain and fever, and can require surgery when infection continues or recurs.
- Gallbladder cancer: Although rare, cancer can affect the gallbladder. It is difficult to diagnose and usually found at late stages when symptoms appear. Symptoms may resemble those of gallstones.
- Gallstone pancreatitis: An impacted gallstone blocks the ducts that drain the pancreas. Inflammation of the pancreas results, a serious condition.
- Abdominal ultrasound: a noninvasive test in which a probe on the skin bounces high-frequency sound waves off structures in the belly. Ultrasound is an excellent test for gallstones and to check the gallbladder wall.
- HIDA scan (cholescintigraphy): In this nuclear medicine test, radioactive dye is injected intravenously and is secreted into the bile. Cholecystitis is likely if the scan shows bile doesn’t make it from the liver into the gallbladder.
- Endoscopic retrograde cholangiopancreatography (ERCP): Using a flexible tube inserted through the mouth, through the stomach, and into the small intestine, a doctor can see through the tube and inject dye into the bile system ducts. Tiny surgical tools can be used to treat some gallstone conditions during ERCP.
- Magnetic resonance cholangiopancreatography (MRCP): An MRI scanner provides high-resolution images of the bile ducts, pancreas, and gallbladder. MRCP images help guide further tests and treatments.
- Endoscopic ultrasound: A tiny ultrasound probe on the end of a flexible tube is inserted through the mouth to the intestines. Endoscopic ultrasound can help detect choledocholithiasis and gallstone pancreatitis.
- Abdominal X-ray: Although they may be used to look for other problems in the abdomen, X-rays generally cannot diagnose gallbladder disease. However, X-rays may be able to detect gallstones.
Gallbladder Scan | Johns Hopkins Medicine
What is a gallbladder scan?
A gallbladder scan is a specialized radiology procedure used to assess the function and structure of the gallbladder. This procedure may also be referred to as a liver-biliary scan because the liver often is examined as well due to its proximity and close functional relationship to the gallbladder.
A gallbladder scan is a type of nuclear medicine procedure. This means that a tiny amount of a radioactive substance is used during the procedure to assist in the examination of the gallbladder. The radioactive substance, called a radionuclide (radiopharmaceutical or radioactive tracer), is absorbed by normal gallbladder tissue.
The radionuclide used in gallbladder scans is usually a form of technetium. Once absorbed into the gallbladder tissue, the radionuclide emits a type of radiation, called gamma radiation. The gamma radiation is detected by a scanner, which processes the information into a picture of the gallbladder.
By measuring the behavior of the radionuclide in the body during a nuclear scan, the doctor can assess and diagnose various conditions, such as obstruction of bile ducts from gallstones, tumors, abscesses, hematomas, organ enlargement, or cysts. A nuclear scan may also be used to assess organ function.
The areas where the radionuclide collects in greater amounts are called “hot spots.” The areas that do not absorb the radionuclide and appear less bright on the scan image are referred to as “cold spots.”
Gallbladder disease may be caused by infection or by a blockage within the gallbladder or the ducts of the liver/gallbladder system (the biliary tree). If the gallbladder is infected or obstructed, the radionuclide cannot pass into the gallbladder. If there is a blockage within the biliary tree, passage of the radionuclide will stop at the point of the obstruction.
Other related procedures that may be used to diagnose problems of the gallbladder include abdominal X-rays, computed tomography (CT scan) of the liver and biliary tract, abdominal ultrasound, cholecystography, or endoscopic retrograde cholangiopancreatography (ERCP).
About the gallbladder
The gallbladder is a pear-shaped organ located in the fissure between the right and left lobes of the liver. The gallbladder stores and concentrates bile, a substance produced by the liver and used to break down fat for digestion.
What are the reasons for a gallbladder scan?
A gallbladder scan may be performed in situations where gallbladder disease (cholecystitis) is suspected, such as with severe acute right upper abdominal quadrant pain or when jaundice (yellowed skin and/or eyes) is present. Elevated liver enzymes in a specific blood test may also indicate some type of gallbladder disease.
A gallbladder scan may also be helpful in diagnosing biliary duct obstructions and determining gallbladder function.
There may be other reasons for your doctor to recommend a gallbladder scan.
What are the risks of a gallbladder scan?
The amount of the radionuclide injected into your vein for the procedure is small enough that there is no need for precautions against radioactive exposure. The injection of the radionuclide may cause some slight discomfort. Allergic reactions to the radionuclide are rare, but may occur.
For some patients, having to lie still on the scanning table for the length of the procedure may cause some discomfort or pain.
Patients who are allergic to or sensitive to medications, contrast dyes, or latex should notify their doctor.
If you are pregnant or suspect that you may be pregnant, you should notify your health care provider due to the risk of injury to the fetus from a gallbladder scan. If you are lactating, or breastfeeding, you should notify your health care provider due to the risk of contaminating breast milk with the radionuclide.
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.
Certain factors or conditions may interfere with the accuracy of a gallbladder scan. These factors may include, but are not limited to, the following:
Presence of a radionuclide in the body from a previous nuclear medicine procedure within a certain period of time
Eating and/or drinking within two to eight hours of the procedure
Prolonged period of fasting (usually greater than 24 hours)
Administration of hyperalimentation (a form of IV nutrition)
How do I prepare for a gallbaldder scan?
PRECAUTIONS: If you are pregnant or think you might be pregnant, please check with your doctor before scheduling the exam. Other options will be discussed with you and your doctor.
BREASTFEEDING: If you are breastfeeding, you should notify your health care provider due to the risk of contaminating breast milk with the tracer.
CLOTHING: You may be asked to change into a patient gown. A gown will be provided for you. Lockers are provided to secure your personal belongings. Please remove all piercings and leave all jewelry and valuables at home.
EAT/DRINK: You will be asked to not eat or drink anything for up to eight hours. You should not fast any longer than the period specified by your doctor, as fasting for too long of time may affect the accuracy of the test as much as not fasting long enough.
ALLERGIES: Notify the radiologist or technologist if you are allergic to or sensitive to medications, contrast dyes or iodine. The injection of the radiotracer may cause some slight discomfort. Allergic reactions to the radiotracer are rare, but may occur.
What happens during a gallbladder scan?
A gallbladder scan may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your doctor’s practices.
Generally, a gallbladder scan follows this process:
You will be asked to remove any jewelry, or other objects that may interfere with the procedure.
You will be asked to remove clothing and will be given a gown to wear.
An intravenous (IV) line will be started in the hand or arm for injection of the radionuclide.
The radionuclide will be injected into your vein.
You will be asked to lie still on a scanning table. You will need to remain still during the procedure, as any movement may affect the quality of the scan.
The scanner will be placed over the abdominal area in order to detect the gamma rays emitted by the radionuclide in the gallbladder tissue. A series of images will be taken at intervals until the gallbladder is visualized.
In some cases, you may receive an IV injection of morphine during the procedure to allow better visualization of the gallbladder during an indeterminate test.
If the radionuclide does not enter the gallbladder within a certain period of time, the scan may be repeated within a few hours to determine if there is a complete or partial obstruction in the biliary tree.
When the scan has been completed, the IV line will be removed.
While the gallbladder scan itself causes no pain, having to remain still for the length of the procedure might cause some discomfort or pain, particularly in the case of a recent injury or invasive procedure such as surgery. The technologist will use all possible comfort measures and complete the procedure as quickly as possible to minimize any discomfort or pain.
What happens after a gallbladder scan?
You should move slowly when getting up from the scanner table to avoid any dizziness or lightheadedness from lying flat for the length of the procedure.
You may be instructed to drink plenty of fluids and empty your bladder frequently for about 24 hours after the procedure to help flush the remaining radionuclide from your body.
The IV site will be checked for any signs of redness or swelling. If you notice any pain, redness, and/or swelling at the IV site after you return home following your procedure, you should notify your doctor as this may indicate an infection or other type of reaction.
If you were asked to fast prior to the procedure, you may either be offered food and drink after the procedure or encouraged to have a meal, unless your doctor tells you differently.
You may resume your usual diet and activities, unless your doctor advises you differently. Your doctor may give you additional or alternate instructions after the procedure, depending on your particular situation.
Liver: Anatomy and Functions | Johns Hopkins Medicine
Anatomy of the liver
The liver is located in the upper right-hand portion of the abdominal cavity, beneath the diaphragm, and on top of the stomach, right kidney, and intestines.
Shaped like a cone, the liver is a dark reddish-brown organ that weighs about 3 pounds.
There are 2 distinct sources that supply blood to the liver, including the following:
The liver holds about one pint (13%) of the body’s blood supply at any given moment. The liver consists of 2 main lobes. Both are made up of 8 segments that consist of 1,000 lobules (small lobes). These lobules are connected to small ducts (tubes) that connect with larger ducts to form the common hepatic duct. The common hepatic duct transports the bile made by the liver cells to the gallbladder and duodenum (the first part of the small intestine) via the common bile duct.
Functions of the liver
The liver regulates most chemical levels in the blood and excretes a product called bile. This helps carry away waste products from the liver. All the blood leaving the stomach and intestines passes through the liver. The liver processes this blood and breaks down, balances, and creates the nutrients and also metabolizes drugs into forms that are easier to use for the rest of the body or that are nontoxic. More than 500 vital functions have been identified with the liver. Some of the more well-known functions include the following:
Production of bile, which helps carry away waste and break down fats in the small intestine during digestion
Production of certain proteins for blood plasma
Production of cholesterol and special proteins to help carry fats through the body
Conversion of excess glucose into glycogen for storage (glycogen can later be converted back to glucose for energy) and to balance and make glucose as needed
Regulation of blood levels of amino acids, which form the building blocks of proteins
Processing of hemoglobin for use of its iron content (the liver stores iron)
Conversion of poisonous ammonia to urea (urea is an end product of protein metabolism and is excreted in the urine)
Clearing the blood of drugs and other poisonous substances
Regulating blood clotting
Resisting infections by making immune factors and removing bacteria from the bloodstream
Clearance of bilirubin, also from red blood cells. If there is an accumulation of bilirubin, the skin and eyes turn yellow.
When the liver has broken down harmful substances, its by-products are excreted into the bile or blood. Bile by-products enter the intestine and leave the body in the form of feces. Blood by-products are filtered out by the kidneys, and leave the body in the form of urine.
Cholecystitis (Gallbladder inflammation), Diagnosis & Treatment
Cholecystitis (ko-luh-sis-TIE-tis) is inflammation of the gallbladder. It usually occurs when drainage from the gallbladder becomes blocked (often from a gallstone). It may be acute (come on suddenly) and cause severe pain in the upper abdomen. Or it may be chronic (multiple recurrent episodes) with swelling and irritation that occurs over time.
Your doctor may use abdominal ultrasound, abdominal CT, magnetic resonance cholangiopancreatography (MRCP) or nuclear imaging to help diagnose your condition. Treatment may include fasting, antibiotic medication and having a drainage tube placed in the gallbladder. However, because it can often reoccur, the most common treatment is to have surgery to remove your gallbladder.
What is cholecystitis?
Cholecystitis means inflammation of the gallbladder. The gallbladder is a pear-shaped organ that sits beneath your liver and stores bile. If your gallbladder is inflamed, you may have pain in the upper right or mid-portion of the abdomen and you may be tender to the touch there.
Bile is made in the liver. The gallbladder stores bile and pushes it into the small intestine where it is used to help digest food. When the drainage pathway for the bile stored in the gallbladder (called the cystic duct) becomes blocked, usually by a gallstone, the gallbladder becomes swollen and may become infected. This results in cholecystitis. The cystic duct drains into the common bile duct, which carries the bile into the small intestine. A gallstone may also become stuck in the common bile duct. This condition (choledocholithiasis) requires a procedure to remove or bypass the blockage.
Cholecystitis may be:
- Acute (occur suddenly) – This inflammation often causes severe pain in the mid or right upper abdomen. Pain can also spread between the shoulder blades. In severe cases, the gallbladder may tear or burst and release bile into the abdomen, causing severe pain. This can be a life-threatening situation that requires immediate attention.
- Chronic (multiple episodes of inflammation) – Recurrent bouts of mild swelling and irritation/inflammation will often damage the wall of the gallbladder causing it to thicken, shrink and lose proper function
Other symptoms include:
- abdominal pain that gets worse when taking a deep breath
- abdominal pain and cramping after meals (especially fatty foods)
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How is cholecystitis diagnosed and evaluated?
Your doctor may order blood tests to see if you have a gallbladder infection. Often, the white blood cell count in our blood may become elevated as a sign of the infection. One or more of the following radiology tests also may be done:
- Abdominal ultrasound: This is often the first test done to evaluate for cholecystitis. Ultrasound uses sound waves to produce pictures of the gallbladder and the bile ducts. It is used to identify signs of inflammation involving the gallbladder and is very good at showing gallstones.
- Abdominal CT: Computed tomography (CT) uses x-rays to produce detailed pictures of the abdomen, liver, gallbladder, bile ducts and intestine to help identify inflammation of the gallbladder or blocked bile flow. Sometimes (but not always) it can also show gallstones. See the Radiation Dose page for more information about CT.
- Magnetic resonance cholangiopancreatography (MRCP): MRCP is a type of MRI exam that makes detailed images of the liver, gallbladder, bile ducts, pancreas and pancreatic duct. It is very good at showing gallstones, gallbladder or bile duct inflammation, and blocked bile flow. See the MRI Safety page for more information.
- Hepatobiliary nuclear imaging: This nuclear medicine test uses an injected radiotracer to help evaluate disorders of the liver, gallbladder and bile duct (biliary system). In acute cholecystitis, it can detect blockage of the cystic duct (the duct that is always blocked with acute cholecystitis).
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How is cholecystitis treated?
Your doctor may suggest:
- fasting to rest the gallbladder
- a special, low-fat diet
- pain medication
- antibiotics to treat infection
However, because the condition may come back often, your doctor may recommend you have your gallbladder removed using either:
- laparoscopic surgery. The surgeon uses the belly button and several small cuts to insert a laparoscope to see inside the abdomen and remove the gallbladder. You will be asleep for the surgery.
- open surgery. The surgeon makes a cut in the abdomen and removes the gallbladder. You will be asleep for the surgery. See the Anesthesia Safety page for more information.
If you cannot have surgery, your doctor may drain bile from the gallbladder. This may be done by:
- Percutaneous cholecystostomy: This procedure is done by a radiologist. It places a tube through the skin directly into the gallbladder using ultrasound or CT guidance. Blocked or infected bile is removed to reduce inflammation. This procedure is typically done in patients who are too sick to have their gallbladder removed. You will be sedated for this procedure. The tube typically has to stay in for at least a few weeks.
- Endoscopic retrograde cholangiopancreatography (ERCP): This procedure is typically done by a doctor who specializes in abdominal disorders (a gastroenterologist). A camera on a flexible tube is passed from the mouth through the stomach and into the beginning of the small bowel. This is where the common bile duct meets the small intestine. The valve mechanism (called the sphincter) at the end of the bile duct can be examined and opened to clear blocked bile and stones, if necessary. Doctors can also insert a small tube into the main bile duct and inject contrast material to better see the duct. They also may use a laser fiber to destroy small gallstones or use a basket or balloon to retrieve stones or stone fragments. All of this may be done without making any incisions in the abdomen. This procedure poses a small, but real risk of pancreas inflammation or injury. You will be sedated for this procedure.
- Percutaneous transhepatic cholangiography (PTC): This procedure is done by a radiologist. A needle is placed in the bile ducts within the liver using imaging guidance. Contrast material is injected to help locate gallstones that may be blocking bile flow. Some stones can be removed during a PTC. Others may be bypassed by leaving a small stent in place to allow bile to get around the area of blockage. This helps reduce inflammation. You will be sedated for this procedure. See the Biliary Interventions page for more information.
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Which test, procedure or treatment is best for me?
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This page was reviewed on March, 23, 2021
Gallbladder | MUSC Health | Charleston SC
What is the gallbladder?
The gallbladder is a small organ that stores bile. It is attached to your digestive system by a system of hollow ducts called the biliary tree.
The gallbladder sits in an indenture underneath the right lobe of the liver. It is about one inch wide and three inches long, and tapered at one end where it connects to the cystic duct. It is a muscular organ that contracts when bile is needed, and forces the enzyme through the cystic duct.
There are three main parts of the gallbladder:
- fundus — the large end that stores bile juices
- body — not as large and begins to taper
- neck — tapers further and connects to the cystic duct
The connection to the cystic duct is known as Hartmann’s Pouch. When gallstones get stuck, it is usually at this juncture.
The gallbladder creates a reservoir for bile, also known as gall, hence the name gallbladder. The bile that is stored here is actually manufactured in the liver. The bladder itself is not very large; however, bile is a strong enzyme.
What does the gallbladder do?
Fat is difficult to digest. It resists being broken down into usable energy. Bile is a strong enzyme that assists in breaking fats down. When the food you eat contains fat, the stomach and duodenum secrete a substance that stimulates the gallbladder to contract, thereby forcing bile into the digestive tract. Bile emulsifies the fat, making it available for energy production.
Why is the gallbladder removed?
The gallbladder stores bile juices and strong enzymes that in some instances can create stones. These stones irritate the lining of the gallbladder, and sometime migrate through the biliary tree. Most of the times this occurs without incident; however, stones can become lodged in the biliary tract. This causes severe pain.
Can I survive without my gallbladder?
Gallbladder removal is a common medical procedure that has little effect on the lifestyle. You may experience some discomfort if you eat a diet high in fat. Remember that the gallbladder stores and secretes enzymes for the purpose of breaking down fat so that it may be used as energy for the body. Your doctor will have more information about any lifestyle changes you may wish to consider.
Stomach, Gallbladder and Pancreas | Interactive Anatomy Guide
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Continued From Above…
Anatomy of the Stomach, Gallbladder, and Pancreas
A hollow muscular organ about the size of 2 closed fists, the stomach is located inferior to the diaphragm and lateral to the liver on the left side of the abdominal cavity. The stomach forms part of the gastrointestinal tract between the esophagus and the duodenum (the first section of the small intestine).
The wall of the stomach contains several layers of epithelium, smooth muscle, nerves, and blood vessels. The innermost layer of the stomach is made of epithelium containing many invaginations known as gastric pits. The cells of the gastric pits produce gastric juice – an acidic mixture of mucus, enzymes and hydrochloric acid.
The hollow portion of the stomach serves as the storage vessel for food before it moves on to the intestines to be further digested and absorbed. At the inferior end of the stomach is a band of smooth muscle called the pyloric sphincter. The pyloric sphincter opens and closes to regulate the flow of food into the duodenum.
The gallbladder is a 3-inch long pear-shaped sac located on the posterior border of the liver. Connected to the bile ducts of the liver through the cystic duct, the gallbladder receives bile transported from the liver for storage on a regular basis to prepare for the digestion of future meals. During digestion of a meal, smooth muscles in the walls of the gallbladder contract to push bile into the bile ducts that lead to the duodenum. Once in the duodenum, bile helps with the digestion of fats.
The pancreas is a 6-inch long heterocrine gland located inferior to the stomach and surrounded by the duodenum on its medial end. This organ extends laterally from the duodenum toward the left side of the abdominal cavity, where it tapers to a point.
The pancreas is considered a heterocrine gland because it has both endocrine and exocrine gland functions. Small masses of endocrine cells known as pancreatic islets make up around 1% of the pancreas and produce the hormones insulin and glucagon to regulate glucose homeostasis in the blood stream. The other 99% of the pancreas contains exocrine cells that produce powerful enzymes that are excreted into the duodenum during digestion. These enzymes together with water and sodium bicarbonate secreted from the pancreas are known as pancreatic juice.
Physiology of the Stomach, Gallbladder, and Pancreas
The stomach, gallbladder, and pancreas work together as a team to perform the majority of the digestion of food.
- Food entering the stomach from the esophagus has been minimally processed — it has been physically digested by chewing and moistened by saliva, but is chemically almost identical to unchewed food.
- Upon entering the stomach, each mass of swallowed food comes into contact with the acidic gastric juice, which contains hydrochloric acid and the protein-digesting enzyme pepsin. These chemicals begin working on the chemical digestion of the molecules that make up the food.
- At the same time, the food is mixed by the smooth muscles of the stomach wall to increase the amount of contact between the food and the gastric juice. The secretions of the stomach also continue the process of moistening and physically softening the food until the food becomes an acidic semi-liquid material known as chyme.
- At this point, the stomach begins to push the chyme through the pyloric sphincter and into the duodenum.
- In the duodenum, the bulk of digestion is completed thanks to the preparation of chyme by the stomach and the addition of secretions from the gallbladder and pancreas. Bile from the gallbladder acts as an emulsifier to break large masses of fats into smaller masses. Pancreatic juice contains bicarbonate ions to neutralize the hydrochloric acid of chyme. Enzymes present in the pancreatic juice complete the chemical digestion of large molecules that began in the mouth and stomach.
- The completely digested food is then ready for absorption by the intestines.
The stomach, gallbladder, and pancreas all function together as storage organs of the digestive system. The stomach stores food that has been ingested and releases it in small masses to the duodenum. The release of small masses of food at a time improves the digestive efficiency of the intestines, liver, gallbladder, and pancreas and prevents undigested food from making its way into feces.
As they are accessory organs of the digestive system, the gallbladder and pancreas have no food passing through them. They do, however, act as storage organs by storing the chemicals necessary for the chemical digestion of foods. The gallbladder stores bile produced by the liver so that there is a sufficient supply of bile on hand to digest fats at any given time. The pancreas stores the pancreatic juice produced by its own exocrine glands so that it is prepared to digest foods at all times.
The stomach, gallbladder, and pancreas all share the common function of secretion of substances from exocrine glands. The stomach contains 3 different exocrine cells inside of its gastric pits: mucous cells, parietal cells, and chief cells.
- Mucous cells produce mucus and bicarbonate ion that cover the surface of the stomach lining, protecting the underlying cells from the damaging effects of hydrochloric acid and digestive enzymes.
- Parietal cells produce hydrochloric acid to digest foods and kill pathogens that enter the body through the mouth.
- Chief cells produce the protein pepsinogen that is turned into the enzyme pepsin when it comes into contact with hydrochloric acid. Pepsin digests proteins into their component amino acids.
The mixture of mucus, hydrochloric acid, and pepsin is known as gastric juice. Gastric juice mixes with food to produce chyme, which the stomach releases into the duodenum for further digestion.
The gallbladder stores and secretes bile into the duodenum to aid in the digestion of chyme. A mixture of water, bile salts, cholesterol, and bilirubin, bile emulsifies large masses of fats into smaller masses. These smaller masses have a higher ratio of surface area to volume when compared to large masses, making it easier for them to be digested.
The pancreas stores and secretes pancreatic juice into the duodenum to complete the chemical digestion of food that began in the mouth and stomach. Pancreatic juice contains a mixture of enzymes including amylases, proteases, lipases, and nucleases.
- Carbohydrates entering the small intestine are broken down into monosaccharides by enzymes such as pancreatic amylase, maltase, and lactase.
- Proteins in the duodenum are chemically digested into amino acids by pancreatic enzymes such as trypsin and carboxypeptidase.
- Pancreatic lipase breaks triglycerides into fatty acids and monoglycerides.
- The nucleic acids DNA and RNA are broken down by nucleases into their component sugars and nitrogenous bases.
Several hormones are used to regulate the functions of the stomach, gallbladder, and pancreas. The hormones gastrin, cholecystokinin, and secretin are secreted by organs of the digestive system in response to the presence of food and change the function of the stomach, gallbladder, and pancreas. Our pancreas produces the hormones insulin and glucagon to affect the behavior of cells throughout the body.
Gastrin is a hormone produced by the walls of the stomach in response to the filling of the stomach with food. Food stretches the stomach walls and raises the normally acidic pH of the stomach. G cells in the gastric glands of the stomach respond to these changes by producing gastrin. G cells release gastrin into the blood where it stimulates the exocrine cells of the stomach to produce gastric juice. Gastrin also stimulates smooth muscle tissue of the gastrointestinal tract to increase the mixing and movement of food. Finally, gastrin relaxes the smooth muscles that form the pyloric sphincter, causing the pyloric sphincter to open. The opening of the pyloric sphincter allows food stored in the stomach to begin entering the duodenum for further digestion and absorption in the intestines.
Cholecystokinin, a hormone produced in the walls of the small intestine, is released into the bloodstream in response to the presence of chyme in the intestine that contains high levels of proteins and fats. Proteins and fats are more difficult for the body to digest than carbohydrates are, so CCK is important in making changes to the digestive system to handle these types of foods. CCK travels through the bloodstream to the stomach, where it slows the emptying of the stomach to give the intestines more time to digest the protein- and fat-rich chyme. CCK also stimulates the gallbladder and pancreas to increase their secretion of bile and pancreatic juice to improve the digestion of fats and proteins. Finally, CCK is detected by receptors in the satiety center of the hypothalamus that control the feeling of hunger. The satiety center reads the presence of CCK as an indication that the body is no longer hungry for food.
Secretin is another hormone produced by the intestinal walls, but unlike CCK, it is produced in response to the acidity of chyme that the stomach releases into the duodenum. Secretin flows through the bloodstream to the stomach, where it inhibits the production of hydrochloric acid by parietal cells. Secretin also binds to receptors in the gallbladder and pancreas, stimulating them to secrete increased amounts of bile and pancreatic juice. Sodium bicarbonate present in pancreatic juice neutralizes the acidity of the chyme to prevent damage to the walls of the duodenum and provides a neutral pH environment for the digestion of chyme.
Insulin is a hormone produced by the beta cells of the pancreatic islets of the pancreas. The pancreas produces insulin in response to the presence of high levels of glucose in the blood. Insulin stimulates cells, particularly in the liver and skeletal muscles, to absorb glucose from the blood and use it as an energy source or store it as glycogen. Insulin also stimulates adipocytes to absorb glucose to build triglycerides for energy storage. Our body produces higher levels of insulin following a meal in order to remove glucose molecules from the blood before they can reach high concentrations and become toxic to the body’s cells.
Glucagon is a hormone produced by the alpha cells of the pancreatic islets of the pancreas. Glucagon acts as an antagonist to insulin by stimulating the release of glucose into the bloodstream to raise blood glucose levels between meals. Hepatocytes in the liver store glucose in large macromolecules known as glycogen. Glucagon binding to receptors on hepatocytes triggers the breakdown of glycogen into many glucose molecules, which are then released into the bloodstream.
What is the Pancreas? – Pancreatic Cancer Action Network
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The pancreas is a gland, about six inches long, located in the abdomen. It is shaped like a flat pear and is surrounded by the stomach, small intestine, liver, spleen and gallbladder. The wide end of the pancreas on the right side of the body is called the head. The middle sections are the neck and body. The thin end of the pancreas on the left side of the body is called the tail. The uncinate process is the part of the gland that bends backwards and underneath the head of the pancreas. Two very important blood vessels, the superior mesenteric artery and superior mesenteric vein, cross behind the neck of the pancreas and in front of the uncinate process. The pancreas is both an exocrine gland and endocrine gland and has two main functions – digestion and blood sugar regulation.
The Pancreas and Digestion
Exocrine cells of the pancreas produce enzymes that help with digestion. When food enters the stomach, exocrine cells release the pancreatic enzymes into a system of small ducts that lead to the main pancreatic duct. The pancreatic duct runs the length of the pancreas and carries pancreatic enzymes and other secretions, collectively called pancreatic juice.
The main pancreatic duct connects with the common bile duct, which carries bile from the gallbladder, and together they connect with the duodenum at a point called the ampulla of Vater. Here, bile and pancreatic enzymes enter the duodenum to aid with the digestion of fats, carbohydrates and proteins.
Blood Sugar Regulation
The endocrine cells of the pancreas produce hormones. Hormones are substances that control or regulate specific functions in the body. They are usually made in one part of the body and carried through the blood to take action on another part of the body. The two main pancreatic hormones are insulin and glucagon. Islet cells are endocrine cells within the pancreas that produce and secrete insulin and glucagon into the bloodstream. Insulin lowers blood sugar levels while glucagon raises blood sugar levels. Together, these two main hormones work to maintain the proper level of sugar in the blood.
Learn About Pancreatic Cancer
Pancreatic cancer begins when abnormal cells in the pancreas grow out of control and form a tumor. The symptoms associated with pancreatic cancer are often vague, similar to symptoms caused by other conditions and may not be present in early stages of the disease. Learn about pancreatic cancer symptoms, types of pancreatic cancer, diagnosis, treatments and more.
We’re Here to Help
For free, in-depth and personalized resources and information on pancreatic cancer, contact PanCAN Patient Services.
The Pancreatic Cancer Action Network would like to thank Kathleen Wagner and support from the Hamill Foundation and the Pickelner Fund for Pancreatic Cancer Research at MD Anderson Cancer Center for the illustrations provided on this page.
ultrasound of the gallbladder with function determination
Ultrasound examination of the gallbladder with the definition of the function is informative, and most importantly absolutely safe and painless manipulation. Thanks to such a diagnosis, many diseases can be detected at an early stage. To obtain reliable results, the procedure requires careful preparation.
To whom the procedure is shown
Since ultrasound does not have a negative effect on the body, diagnosis is indicated not only for adults, but also for children. Most doctors say that it is mandatory to undergo an ultrasound scan for the following complaints:
- Constant nausea
- Belching with an unpleasant taste in the mouth
- Pain in the gallbladder of unknown etiology
- Regular heaviness in the abdomen
- Lack of appetite
- Changes in skin color
Also, experts do not recommend delaying the examination in the following cases:
- Internal injuries
- Long-term drug treatment
- Severe poisoning
- Suspicion of stones, malignant neoplasms and congenital malformations of the gallbladder
- Chronic pancreatitis, cholecystitis
For infants, such an examination may be prescribed due to unstable stools of unknown etiology or with profuse vomiting of a regular nature.Older children may independently report disturbing symptoms. They usually indicate pressing and unpleasant pain at the location of the gallbladder.
If you suffer from the ailments listed above, go to a medical facility as soon as possible and get diagnosed.
Unlike other studies, ultrasound examination has no direct contraindications. An exception is the violation of the integrity of the skin in the investigated area (for example, burns).
What the ultrasound will show
Based on the results of the examination, it is possible to identify such diseases as:
- Cholecystitis of various forms
- Presence of stones in the gallbladder
- Congenital malformations of organ
- Presence of neoplasms
- Change in the structure and size of the organ
If a disease is detected in a timely manner, in this case, one can hope for a successful outcome. Most pathologies at an early stage can be cured with medication. If we are talking about an advanced form of the disease, surgical intervention may be required.
How to properly prepare
For the results to be informative, the patient must receive special training. Three days before the appointed date of the study, it is required to stop eating fried, spicy, too fatty and smoked foods. Also banned are alcoholic beverages, bread, mushrooms, soda, various fast food, flour and confectionery.These days, a low-calorie diet is shown, consisting of cereals in water, dietary meat, vegetables and fruits (exclusively after heat treatment), as well as fermented milk products.
If the patient is worried about bloating or flatulence, three days in advance, you need to start taking carminative drugs according to the instructions. Be sure to discuss your medications with your doctor who ordered the test. Consider a few rules that must be observed on the eve of an ultrasound of the gallbladder with the definition of the function:
- The last meal must be completed at least 12 hours in advance. Dinner should be light, best of all – consisting of fermented milk products, for example, low-fat cottage cheese with sour cream and a glass of green tea. For a small child, the last meal is recommended 3-4 hours before the ultrasound scan
- Before the study, it is recommended to cleanse the intestines from feces. If you cannot do this in a natural way, do a cleansing enema
- Wake up in the morning, refuse breakfast
- Smoking and chewing gum are strictly prohibited in 3-4 hours
- If you use any medications, be sure to notify your doctor about it
Consult your doctor about preparing for the examination of your child.The fact is that, depending on age and other individual characteristics, a specialist can make some adjustments to the preparation process.
Ultrasound examination of the gallbladder with determination of function usually takes 1 to 2 hours. For this reason, “at the request” of the patient, this type of examination is not carried out – only on the basis of indications and directions from the attending physician. Diagnostic manipulation is carried out in several stages.
First, the person lies on the couch on his back, takes off his clothes to the waist.A standard examination is carried out using a special sensor. For better sliding, the test area is lubricated with a silicone-based gel. The specialist determines the size of the organ, structures, and more. In a word, an ultrasound scan of the gallbladder is performed first of all without examining its function. This diagnostic procedure is performed exclusively on an empty stomach.
The second stage is the study of the function of the organ. Many people wonder why they conduct an initial examination without breakfast? This is necessary so that the doctor can assess the state of the organ’s work before and after eating, since many patients complain of unpleasant symptoms just after eating.A patient in an ultrasound doctor’s office eats breakfast, usually consisting of fermented milk products or boiled chicken eggs. Further, a re-examination is carried out.
The third stage has no peculiarities. Food is allowed to digest a little and after half an hour, ultrasound is performed again. Final check – one hour after breakfast. The specialist examines the organ in various body positions: sitting, lying on the right and left sides, standing.
Interpretation of results
Firstly, do not worry too much if the doctor sent you to the diagnosis of the gallbladder.According to statistics, in most cases, all disturbing symptoms are associated only with improper diet or alcohol abuse. Oncological diseases in this localization are found extremely rarely. When performing an ultrasound examination with the definition of a function, the doctor evaluates the following factors:
- Body length
- The state of the mucous membrane
- Gallbladder contours
- Presence of foreign bodies
After a person has eaten, the volume of the gallbladder should decrease slightly, by about 45-55% compared to the results at the first stage of the study.
Norm of the gallbladder
Normally, this body has the following indicators:
- Length varies from 6 to 9 centimeters
- Width – 2-4 cm
- Capacity up to 70 cm3
- Wall thickness is 3 mm
The gallbladder without abnormalities and pathologies has clear contours. The shape of the organ is pear-shaped. Please note that, depending on individual characteristics, these figures may vary slightly.For example, the age and weight of a person plays a role. To be sure of your results, consult a specialist in this field.
In order not to have to resort to various types of examinations and further worry about the results, spend money on treatment, etc., it is enough to observe proper nutrition and lead a healthy lifestyle. Start by giving up alcohol, nicotine, fatty, smoked foods. Keep track of the amount of salt (no more than 5 grams per day), drink enough water and move more.
Seek medical attention immediately if you have any troubling symptoms. Remember that early diagnosis greatly simplifies and shortens treatment time.
90,000 Which parts of the body scientists have learned to transplant, and which not
- Eva Ontiveros
Photo author, Getty Images
In 2015, the world was produced in a total of more than 126 thousand organ transplants.This is an average of 14.5 transplants per hour.
In the overwhelming majority of cases, it was about the transplantation of body parts necessary for the continuation of life. Most (41.8%) were kidney transplants, followed by liver and heart.
In recent years, the number of lung, pancreas and small intestine transplants has also increased.
Doctors have learned to transplant not only organs, but also various tissues. Transplants of bone marrow, tendons, cornea, skin, heart valves, nerves and veins are quite common.
However, many parts of the body still cannot be replaced. What and why?
Photo author, Getty Images
A head transplant is not possible – and will hardly be possible in the foreseeable future.
“We must focus on the achievable. Over the past 50 years, we have achieved a lot in transplants of all parts of the body below the neck,” says Gabriel Oniscu, Consultant Transplant at Royal Edinburgh Hospital and Secretary of the European Society for Organ Transplantation.
Lorna Mason, transplant surgeon and president of the British Transplant Society, agrees. After all, the goal of doctors is to save the lives of as many people as possible, so it is necessary to “choose the most realistic options.”
In addition to the obvious philosophical controversy (whether the brain is transplanted into the body or is the body transplanted to the brain?), The main difficulty of this kind of operation was the problem of connecting the brain to the spinal cord.
Most transplant surgeries face the problem of successfully connecting blood vessels, but the spinal cord, which is responsible for movement, is a network of highly specialized nerve cells called neurons.
Photo author, Getty Images
The spinal cord is a network of nerve cells
Cells of this type transmit information using electrical and chemical signals, and if they are damaged, it will be impossible to replace them or re-link them together.
This explains why serious spinal cord injuries are often incurable today.
Dr. Mason says that in the event of brain injury or damage due to illness, “there are more realistic options – like replacing cells where possible.”
Scientists are developing a cell therapy that, in some cases, will allow neurons to regenerate and develop.
“Cellular therapy can stop and in some cases even reverse the development of degenerative brain tissue disease,” says Dr. Mason. “This kind of treatment can help people with dementia or multiple sclerosis.”
Photo author, Getty Images
The retina is located at the back of the eyeball and is responsible for converting light into a visible image
Although successful corneal transplants have been carried out for several decades, they are still it is impossible to transplant the retina – the inner part of the eyeball that allows us to see objects and images.
This part of the body again includes many branched nerve connections, so that the transplantation of such a complex neural structure is still beyond modern technical capabilities.
And although the list of completely impossible transplants is limited to these two organs, there are transplant operations that have not yet become commonplace for surgeons.
After any transplant surgery, the patient will have to spend the rest of his life on immunosuppressive drugs to avoid rejection of the new organ, and in the case of the gallbladder, it just isn’t worth it.
“Any transplant is a balance between the benefit of the patient and the inevitable consequences: recovery from such an operation and the need to take medications for the rest of his life,” explains Lorna Mason.
Photo author, Getty Images
The gallbladder, which is painted green on this model, is a useful but not vital organ, says Dr. Gabriel Oniscu
The gallbladder is located under the liver and contains bile – a liquid. which is secreted into the small intestine and aids in digestion.It simplifies your life, but it is not essential.
“It’s like an appendix. If the gallbladder regularly forms stones or is affected by disease, it will be healthier to remove it. We can live well without it,” says Dr. Oniscu.
In this case, the patient is advised to change the diet and lifestyle in order to facilitate digestion.
Dr. Oniscu says the spleen is a slightly different case, as it is “the organ that filters, repairs and stores red blood cells.”But at the same time, according to him, the spleen is also not necessary to sustain life, so the same principle applies to it.
After removing the spleen, the patient must take antibiotics for life – but again, it’s all about balance and what is more effective for the patient.
“Removal and antibiotics are less of a risk than having a transplant and taking medication for the rest of your life to avoid rejection,” says Mason.
The future of tra n spplantations
Photo author, Getty Images
Transplantation does not stand still
The focus will always be on those parts of the body that support life, however, says Dr. Oniscu , “the organs are being transplanted for some reason, it must meet the patient’s need.”
“This is why, for example, we do a uterus transplant,” he explains. “You can live without this organ, but the patient may feel that she will not fulfill her life’s purpose if she does not have children. specific patient “.
Doctors are confident that in the future it will be possible to help patients not only with traditional organ transplants such as liver, heart or lung, but also through cell regeneration and transplantation.
“An ideal example is transplanting cells from the islets of Langerhans for diabetes,” says Dr. Oniscu, referring to the tiny clumps of cells that secrete insulin.
Photo Credit, Getty Images
Stem Cell Transplants May Be an Alternative to Organ Transplants
As demand grows, doctors are exploring more sophisticated treatment strategies that go beyond organ transplants and cell therapy – and transplants are becoming more common complemented by regenerative medicine, new technologies and bioengineering.
Onisku says: “We are studying artificial organs, that is, organs that are restored with the help of stem cells, and probably even organs grown in a different environment – xenotransplants. ” This is the name of donor organs or tissues of animal origin, as well as human organs grown in the body of an animal for subsequent transplantation to humans.
Mason points out that in the end, “the success of a transplant comes down to the results of teamwork and the contribution of a huge team of experts.”
What foods will help you avoid gallstones
The presence of stones in the gallbladder can lead to very painful consequences
Fatty acids, curcumin and antioxidants help to avoid many problems.
Gallstones can last for years without causing complications, but sooner or later they lead to health problems such as pancreatitis, bile duct infection, or even gallbladder cancer. However, there are a number of nutrients that can help reduce your risk of developing stones. The portal “MedikForum” writes about it.
Fish oil. This product reduces inflammation, strengthens the cardiovascular system and relieves symptoms of depression due to its high content of omega-3 fatty acids.But apart from this, fish oil is able to prevent the development of gallstones due to the deactivating effect on cholesterol crystals, which lead to the formation of stones.
Turmeric. Turmeric has been known since ancient times for its ability to relieve inflammation and fight infectious diseases. Modern research has shown that the active ingredient, curcumin, can also improve the absorption of cholesterol and lipids, improve bile flow and improve bile acid metabolism.
Green tea. This drink has many health benefits due to the antioxidants it contains. One of these is epigallocatechin gallate. Research in animals has shown that this component reduces the risk of gallstones and also prevents the development of several other diseases of the gallbladder. Scientists from China published the results of their observations of volunteers and it turned out that green tea also has a positive effect on people: drinking one cup of tea a day for six months reduces the risk of developing stones by 27%, the risk of bile duct tumors by 35%, and the risk of cancer the gallbladder by 44%.
MEDISON.RU – Radiation diagnostics of pathology of the gallbladder and biliary tract
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Diseases of the gallbladder is a special section in modern medicine, to which specialists pay special attention [1-8].On the one hand, the pathology of the gallbladder (for example, polyps) can be completely asymptomatic, but tends to malignancy [4-10]. On the other hand, some diseases, such as calculi of the gallbladder and biliary tract, are accompanied by severe bouts of pain and can lead to severe complications. As a result of prolonged pressure with a stone on the mucous membrane of the bladder, ulcers and pressure ulcers may appear in it, diverticulum-like protrusions, internal and external biliary fistulas, perforated holes with the development of subhepatic or subphrenic abscesses, and biliary peritonitis may form.The movement of gallstones can be accompanied by a blockage of the cystic duct, dropsy of the gallbladder or its empyema. When a stone obstructs the outlet of the common bile duct, obstructive jaundice occurs. Long-term presence of a stone in the bile ducts and the addition of infection lead to the development of cholangitis. The prolapse of a large gallstone from the gallbladder into the intestine through the formed anastomosis can lead to intestinal obstruction [1, 3, 5-8, 10-12]. Therefore, timely diagnosis of diseases of the gallbladder and duct system is very important.
The formation of bile in the liver is a continuous process, but its entry into the intestine normally occurs mainly in the process of digestion. This is provided by the reservoir function of the gallbladder and its rhythmic contractions with successive relaxation of the Lutkens sphincter and then the Oddi sphincter located at the confluence of the common bile duct into the intestine (Fig. 1).
Fig. 1. Schematic representation of the position of the gallbladder on the visceral surface of the liver.
1 – the bottom of the gallbladder;
2 – cystic duct;
3 – own hepatic artery;
4 – portal vein;
5 – gastro-hepatic ligament;
6 – the left lobe of the liver;
7 – caudate lobe of the liver;
8 – inferior vena cava;
9 – caudate process;
10 – neck of the gallbladder;
11 – the right lobe of the liver;
12 – the body of the gallbladder;
13 – square lobe of the liver.
On an empty stomach, the gallbladder contains 30-80 ml of bile, but it can concentrate hepatic bile 5-10 times more. With stagnation of bile in the bladder, its amount may increase. In women, the gallbladder in a state of functional rest has a slightly larger volume than in men, but it contracts faster. With age, the contractile function of the gallbladder decreases.
Ultrasonography is one of the most informative and accessible instrumental methods for diagnosing gallbladder diseases [4-10].
The acoustic properties of ultrasound make it possible to detect the smallest echogenic structures in the gallbladder.
With the help of ultrasound, the time of the diagnostic search is significantly reduced. Unlike computed tomography (CT) and magnetic resonance imaging (MRI) with ultrasound, the research doctor himself is directly involved in obtaining the image, which has its pros and cons. The possibility of a more focused and detailed study of the object under study is positive.The negative side is that the quality of the image and its decoding largely depend on the experience of the researcher and the correctness of the methods used by him.
Polyps in the gallbladder are present in 6% of the total population. In 80% of cases, polyps in the gallbladder are observed in women who have given birth after the age of 30 years. Since polyps do not manifest themselves clinically in any way, their diagnosis is most often accidental and occurs when an ultrasound scan is performed on a patient for completely different reasons [4-10].
Although the causes of the appearance of polyps on the walls of the gallbladder are not established, and the symptoms are not obvious, four types of such formations are known.Most often, according to statistics, the following types are found in the gallbladder in patients today [4, 5, 9].
Inflammatory polyp of the gallbladder – is a kind of inflammatory reaction of the mucous membrane of the gallbladder itself, manifests itself in the patient in the form of various growths of the granulation internal tissue of the affected organ.
Often, doctors also diagnose gallbladder adenoma. This is because it is a kind of benign tumor in the form of a polypoid growth of the glandular tissue of the patient’s gallbladder.
Also noteworthy is papilloma or gallbladder polyposis in some patients. Such a papilloma is a benign tumor of the mucous membrane of the bladder in the form of papillomas or papillary growths of various types and structures.
The most common type is the so-called cholesterol polyp of the gallbladder, which is an elevation of the mucous membrane of the bladder with cholesterol deposits on it.Cholesterosis is quite common among patients referred for surgery with a clinical diagnosis of “polyps” or “gallbladder polyposis”, according to some data from 42 to 95% of cases.
Ultrasonography is an effective means of detecting polypoid forms of cholesterosis [4-10]. The following sonographic characteristic of cholesterol polyps is considered traditional: immobile hyperechoic structures that do not give an acoustic shadow and are attached to the wall of the gallbladder.The contours of such formations, as a rule, are even, and the sizes of such formations are different, more often they do not exceed 10 mm (Fig. 2).
Fig. 2. Ultrasound picture of polyps in the gallbladder.
a) Single polyp in the gallbladder (hyperechoic parietal motionless formation, with smooth contours, without acoustic shadow).
b) Single polyp in the gallbladder.
c) Polypoid-reticular form of cholesterosis, polyps up to 5 mm in size, increased echogenicity.
g) Single polyp in the gallbladder.
However, according to some reports, the size of cholesterol polyps can be more than 20 mm. In addition, large polyps (7% of the total) may have reduced echogenicity and scalloped contour.
Small cholesterol inclusions forming a diffuse mesh in the thickness of the submucosal layer measuring 1-2 mm look like a local thickening or compaction of the gallbladder wall and in some cases (see Fig. 2) cause reverberation (echographic symptom “comet tail”).
With advanced cholesterosis, multiple hyperechoic formations are visualized, giving a picture of a “strawberry” gallbladder (Fig. 3).
Fig.3. Ultrasound picture of polyps in the gallbladder.
a) Multiple polyps in the gallbladder, a picture of a “strawberry” gallbladder.
b) In the color Doppler mapping mode, blood flow is not recorded.
The nature of the leg of the polyp is traditionally taken into account in oncological practice as a sign associated with the malignant nature of the formation. The likelihood of possible malignancy is greater if it has a wide base, rather than a thin leg. However, it is necessary to take into account the possibility of false-positive diagnosis of a wide base in large polyps due to their limited displacement in the lumen of the gallbladder.Trembling, reminiscent of a candle flame, is observed in polyps of small size and elongated shape, and indicates their thin stem [4-10].
Gallstone disease (cholelithiasis; calculous cholecystitis) is a disease caused by the presence of stones in the gallbladder and bile ducts. The incidence of gallstone formation increases with age, reaching 45-50% in women over 80. In men, gallstones are 3-5 times less common, in children – extremely rare. Only in 20% of cases gallstones are asymptomatic (“silent” calculi) .
There are two main mechanisms for the formation of gallstones: hepatic and vesicoureteral. The hepatic-metabolic mechanism consists in the formation of gallstones due to such factors as unbalanced nutrition with a predominance of non-coarse animal fats (pork, lamb, beef) in the diet to the detriment of vegetable fats; neuroendocrine disorders, for example, associated with age-related endocrine system dysfunction and hypofunction of the thyroid gland; lesions of the hepatic parenchyma of toxic and infectious genesis; hypodynamia and stagnation of bile.As a result, the liver produces lithogenic bile, i.e., capable of forming cholesterol or mixed stones. With the gallbladder mechanism, gallstones are formed under the influence of the inflammatory process in the gallbladder, leading to physicochemical changes in the composition of bile (dyscholia). A change in the pH of bile to the acidic side, characteristic of any inflammation, leads to a decrease in the protective properties of colloids, in particular protein fractions of bile, the transition of the bilirubin micelle from a suspended state to a crystalline state.In this case, a primary crystallization center is formed with the subsequent layering of other ingredients of bile, mucus, epithelium, etc.
Gallstones are dense formations, the number of which can range from one to several thousand, size – up to several centimeters in diameter, weight – up to 30 g or more. In the gallbladder, stones of a round shape are more common, in the common bile duct – ellipsoidal or oblong, in the intrahepatic ducts branched. Depending on the composition, cholesterol, pigment-cholesterol, cholesterol-pigment-calcareous, pigment and calcareous stones are distinguished; when cut, they have a pigment core and a layered structure.
The clinical picture of gallstone disease is diverse [5-6, 10]. Conditionally distinguish chronic pain, chronic recurrent, dyspeptic, angina pectoris and a number of other clinical forms. A characteristic ultrasound sign of a calculus in the gallbladder is its acoustic shadow. This shadow occurs due to the high density of the stone compared to soft tissue. The presence or absence of a shadow helps to distinguish a stone from a gallbladder polyp (Fig. 4).
Fig.4. Ultrasound picture of stones in the gallbladder.
a) Single gallbladder calculus (mobile hyperechoic structure, giving a clear shadow path).
b) Multiple gallbladder calculi.
c) Multiple stones of the gallbladder, change in location when changing the position of the body (mobility of stones).
g) Disconnected (completely filled with calculi) gallbladder, decrease in the size of the gallbladder (wrinkling).
Choledocholithiasis. It is possible to assume the presence of calculi in the bile ducts primarily on the basis of the classic Charcot triad – pain in the upper part of the right or in the middle of the abdomen, chills with fever and jaundice. However, this triad occurs only in 30% of patients with choledocholithiasis. According to the literature, approximately 75% of patients with choledocholithiasis complain of pain in the right upper quadrant of the abdomen or epigastric region, and cholestatic jaundice develops in some patients, in 18-84% of cases it is present in anamnesis or is present at the time of examination [1, 2, 11 -13].
The most difficult clinical diagnosis is asymptomatic choledocholithiasis, which occurs in 19.8% of patients.
The fate of a calculus in the common bile duct can be different. He can, together with the current of bile, “slip” through the sphincter of Oddi into the duodenum (duodenum), without causing any complications. This option is possible if the calculus is small (1-3 mm). Another option is a valve stone (more than 3 mm) in the common bile duct, which does not interfere with the outflow of bile, but also does not go out into the intestine.Such a calculus can be in the common bile duct for days, months and even years, increasing in size. Eventually, it clogs the common bile duct, causing a disturbance in the outflow of bile from the liver and / or pancreatic juice from the pancreas. Even the smallest stone can cause this blockage. Blockade of the common hepatic duct disrupts the outflow of bile from the liver, obstructive jaundice develops.
Well-known sonographic signs of choledocholithiasis are divided into direct and indirect.Direct ultrasound signs include the expansion of the common bile duct more than 7 mm and the presence of hyperechoic structures of various sizes in its lumen, giving a shadow path. Indirect ultrasound signs include biliary hypertension, an increase in the head of the pancreas, the presence of changes in the liver parenchyma in the paravesical zone. However, the localization of the stone in the intrapancreatic part of the common bile duct and in the ampulla of the Vater’s papilla significantly complicates its diagnosis. If the size of the stone is less than the diameter of the common bile duct, or it partially blocks the lumen of the duct, jaundice may be remitting in nature.In such cases, complete obturation can occur when the stone moves along the duct and clogs the common bile duct in places of physiological narrowing. Then there is persistent biliary hypertension with a corresponding clinical picture of jaundice [1-3, 11, 13].
As an illustration, we present our own clinical observations.
Clinical observation 1
Patient T., 62 years old, was admitted to the clinic with complaints of pain in the right hypochondrium, yellowing of the skin.
From the anamnesis it is known that in 1991 the patient underwent cholecystectomy for cholelithiasis.
An ultrasound of the abdominal organs performed upon admission revealed that the liver was slightly enlarged, the echo structure was diffusely heterogeneous, increased echogenicity, and dilated intrahepatic ducts were visualized. Portal vein 12 mm. The gallbladder was removed. The common bile duct is expanded to 15 mm, narrowed towards the terminal section.In the lumen of the common bile duct, there are multiple calculi with a diameter of 8 to 15 mm. The pancreas is of normal size, the contours are even, clear, the structure is heterogeneous, of increased echogenicity, the duct is 1 mm. The spleen is of normal size, structurally unchanged. Splenic vein 7 mm. Conclusion: condition after cholecitectomy. Ultrasound picture of low hepatic block caused by choledocholithiasis (Fig. 5).
Fig.5. Ultrasound picture of choledocholithiasis.
a, b) In the lumen of the common bile duct there are multiple hyperechoic structures of various diameters, giving a clear acoustic shadow.
To clarify the diagnosis, endoscopic retrograde cholangiopancreatography ( ERCP ) with endoscopic papillosphincterotomy ( EPST ) was performed.The mouth of the BDS was cannulated with a lateral papillotome, the aspiration test was positive, and cloudy bile was obtained. With the introduction of 40 ml of contrast agent, the enlarged common bile duct up to 25 mm, lobar and segmental ducts, multiple rounded moving shadows of calculi from 0.8 to 20 mm are contrasted. Lateral papillotome incision within the anatomical range of 1.0 cm. During the revision of the common bile duct with the Dormia basket, 3 calculi with a diameter of 15 to 20 mm were extracted, putty bile with flakes. The contrast drop in the duodenum is moderate.Conclusion: choledocholitholite extraction (Fig. 6).
Fig. 6. Endoscopic retrograde cholangiopancreatography.
a, b) Concrements of the common bile duct. The presence of multiple filling defects against the background of a contrasting shadow of the common bile duct, manifested by rounded and polygonal areas of enlightenment along the shadow of the bile ducts.
Given the presence of large calculi and the inability to remove all calculi with ERCP, the patient underwent choledocholithotomy, choledocholitholite extraction.
The postoperative period was uneventful. In a satisfactory condition, the patient was discharged under the supervision of a surgeon at the place of residence.
Clinical observation 2
Patient L., 74 years old, was admitted to the clinic with a diagnosis of cholelithiasis. Chronic calculous cholecystitis. Multiple choledocholithiasis. Obstructive jaundice of severe degree. Purulent cholangitis.
An ultrasound of the abdominal organs revealed: the liver is slightly enlarged, the contours are even, clear, the structure is heterogeneous, with increased echogenicity. Portal vein 12 mm. Expansion of the intrahepatic ducts, lobar 5 mm, the common hepatic duct (ACD) expanded to 20 mm, the lumen is represented by structures according to the density of small calculi, putties spreading to the lumen of the right lobar duct.The gallbladder is 89×32 mm in size, the wall is 2 mm, and there are similar masses in it. The common bile duct is 15 mm, the lumen is also represented by calculi and putty. The pancreas is of normal size, the contours are even, the structure is diffusely heterogeneous, of increased echogenicity, the duct is not dilated. Spleen of normal size, medium echogenicity, splenic vein 7 mm. Conclusion: calculi of the gallbladder. Ultrasound picture of low hepatic block caused by choledocholithiasis (Fig. 7).
Fig.7. Ultrasound picture of choledocholithiasis.
a) Enlarged gallbladder (blue arrow), calculi of the common bile duct (red arrow).
b) Multiple hyperechoic structures in the lumen of the common bile duct, with a clear shadow path.
During ERCP it was found: OBD is located in a typical place, 1 cm in diameter, at the bottom of the diverticulum without signs of inflammation, up to 0.4 cm in diameter. The mucous membrane above it is hyperemic. The mouth is visualized. Bile is not supplied. The longitudinal fold is partially visible, since it is located almost completely in the diverticulum. Cannulation of OBD with lateral papillotomas. The aspiration test is positive.Introduced 20 ml of contrast agent. The common bile, common hepatic, lobar hepatic, terminal sections of the segmental ducts are contrasted. In the lumen of the common bile duct, multiple filling defects from 0.5 to 2 cm are determined, the common bile duct is expanded to 2.5 cm in diameter. After revision with a Dormia basket, 4 calculi of 1 cm each and many small ones up to 0.5 cm were removed. Outflow in the duodenum was restored. A calculus up to 2 cm in diameter is located 12 cm from the papilla, it is not possible to capture the calculus with a basket and cannot be removed.Lost drainage is installed above the calculus level. Conclusion: choledocholithiasis, choledocholitholite extraction, purulent cholangitis (Fig. 8).
Fig. 8. Endoscopic retrograde cholangiopancreatography. Multiple calculi of common bile duct.
a) Choledoch, completely filled with calculi.
b) Choledoch with calculi (red arrow), contrast discharge into the intestine (blue arrow).
Considering the presence of large calculi and the impossibility of removing them with ERCP, the patient underwent cholecystectomy and choledocholithotomy.
Clinical observation 3
Patient K., 85 years old, was admitted to the clinic with complaints of yellowing of the skin after a painful attack, diagnosed with cholelithiasis. Chronic calculous cholecystitis. Choledocholithiasis. Obstructive jaundice of mild severity.
An ultrasound of the abdominal cavity revealed: the liver is of normal size, the structure is diffusely heterogeneous, the intrahepatic ducts are dilated, the lobar ducts are up to 8 mm.Portal vein 12 mm. The gallbladder is 100×34 mm in size, in the lumen there are mobile calculi up to 8 mm in diameter. Common bile duct – 17 mm, calculus in the lumen – up to 13 mm. The pancreas is of normal size, the contours are even, clear, the structure is heterogeneous, of increased echogenicity, the duct is 1 mm. The spleen is of normal size, the splenic vein is 7 mm. Conclusion: calculi of the gallbladder. Ultrasound picture of low hepatic block caused by choledocholithiasis (Fig. 9-11).
Fig.9. Ultrasound picture of the expansion of the intrahepatic ducts, common bile duct and the right lobar duct.
a) Intrahepatic ducts.
b) Right lobar duct.
Fig. 10. Ultrasound picture of calculi.
a) A hyperechoic dense structure with a clear shadow path is visualized in the common bile duct.
b) Concretions in the common bile duct (red arrow) and in the gallbladder (blue arrow).
Fig. 11. Ultrasound picture of calculi.
a) Concrements in the gallbladder.
b) Concretions in the gallbladder (blue arrow) and dilated common bile duct (red arrow).
For diagnostic and therapeutic purposes, ERCP, EPST, choledocholitholite extraction were performed. The OBD is located in a typical place, the size is 0.5 cm. The longitudinal fold is tense, bile comes in. Cannulation of the BDS orifice with a lateral papillootome. The aspiration test is positive. Introduced 15.0 ml of contrast agent. Choledoch – 1.5 cm.In the lumen there is a calculus 0.9 cm in size.The longitudinal fold is dissected over a length of 1.0 cm.During the revision with the Dormia basket, the calculus was removed. Contrast relief is good. Conclusion: choledocholithiasis, choledocholitholithiasis (Fig. 12).
Fig. 12. Endoscopic retrograde cholangiopancreatography.
a) Concrement in the common bile duct.
b) Concretions in the gallbladder (blue arrow), in the common bile duct (red arrow).
Considering the age and somatic condition of the patient, surgical treatment for cholelithiasis was postponed.
Thus, ultrasound is the “gold standard” in determining polyps and calculi in the gallbladder, and also allows you to always determine the indirect signs of choledocholithiasis.As for the presence of direct signs of choledocholithiasis (determination of calculus in the bile ducts), here endoscopic retrograde cholangiopancreatography, which is also a therapeutic manipulation, is more informative.
- Amosov V.I., Bubnova E.V., Shchetinin V.N., Mosyagina S.G., Bryzgalova S.B., Putilova I.V. Radiation diagnostics of small calculi of hepaticoholedochus // Scientific notes of the St.acad. I.P. Pavlova. 2009. T. XVI. N3.
- Amosov V.I., Bubnova E.V., Shchetinin V.N. Features of X-ray diagnostics of small stones of hepaticoholedochus in endoscopic retrograde cholangiopancreaticography // Materials of the 2nd All-Russian National Congress on Radiation Diagnostics and Therapy: Collection of articles. scientific works. Moscow. 2008.
- Bubnova E.V., Shchetinin V.N. Features of X-ray diagnostics of small calculi of hepaticoholedochus in ERCP.Materials of the scientific-practical conference dedicated to the 50th anniversary of the city clinical hospital N20: collection of articles. scientific. tr. St. Petersburg. 2008.
- Nikitina M.N., Pimanov S.I., Lud N.G. Ultrasound examination and management of patients with gallbladder polyps // Med. news. 2002. N9. S. 62-64.
- Roshinsky S.M., Fedoruk A.M. Intraluminal formations of the gallbladder: the results of ultrasound studies // Materials of scientific-practical.conf., dedicated. 10th anniversary Minsk. diagnostic center. Minsk, 1999.S. 77-78.
- Savelyev B.C., Petukhov V.A., Boldin B.V. Cholesterosis of the gallbladder. Moscow: VEDI, 2002.192 p.
- Sugiyama M., Atomi Y., Kuroda E. et al. Large cholesterol polyp of the gall bladder: diagnosis by means of US and endoscopic US // Radiology. 1995. V. 196. N2. P. 493-497.
- Seo D.W., Kim H.J., Kim D.I., Park E.T., Yoo K.S., Lim B.C., Myung S.J., Park H.J., Min Y.I. A new strategy to predict the neoplastic polyps of the gallbladder based on scoring system using EUS // Gastrointest Endosc. 2000. V. 52. N3. R. 372-379.
- Nikitina M.N., Pimanov S.I. Ultrasound diagnostics of gallbladder cholesterosis // SonoAce-Ultrasound. 2004. N12.
- Liu C.L., Lo C.M., Chan J.K.F., Poon R.T.P., Fan S.T. EUS for detection of occult cholelithiasis in patients with idiopathic pancreatitis // Gastrointest Endosc.2000. V. 51. P. 28-32.
- Bubnova E.V., Bryzgalova S.V., Putilova I.V., Kamenskaya O.V. Radiation diagnostics of small calculi of hepaticoholedochus // Materials of the IV All-Russian National Congress of Radiation Diagnosticians and Therapists “Radiology-2010”. Moscow. 2010.
- Potashov L.V., Shchetinin V.N., Kudrevatykh I.P., Polyglotgov O.V., Bubnova E.V. Endoscopic treatment of complicated forms of choledocholithiasis // Abstracts of the VI International Congress on Endoscopic Surgery: Collection of articles.scientific. tr. Moscow. 2004.
- Bubnova E.V. Methods for detecting small stones of hepaticoholedochus in endoscopic retrograde cholangiopancreaticography // Materials of the Nevsky radiological forum: collection of articles. scientific. tr. St. Petersburg. 2009.
Ultrasound machine HS40
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It is necessary to normalize the outflow of bile
Hello! I am 40 years old. Disturbed by the pain in
right hypochondrium, a sharp swelling of the intestines,
plaque on the tongue and bad breath.On
Ultrasound doctor found kink of the gallbladder
and signs of chronic pancreatitis. The doctor appointed
I would like to know about the reasons for the inflection and
ways to treat it. Can I take syrup
holosas? I would also like to understand the reason
bloating of the intestines. What tests or examinations
i need to do to determine
trouble? What kind of diet should you follow?
Pain in the right hypochondrium
for a long
time may be
a sign of cholecystitis
– inflammation of the bile
We used to hear about
the fact that cholecystitis is associated
with stones in the gall
bladder that interfere
normal outflow of bile,
which leads to the emergence
and can even provoke
an attack of jaundice.
However, most often in our
days the so-called
cholecystitis. This inflammation
gallbladder caused by
not by the appearance
there are stones in it, and others
reasons. One of them
maybe just an inflection
this also violates
normal outflow of bile:
it accumulates in the gall
his.This, in turn,
aggravates the kink and more
worsens conditions more
to excrete bile from
intestine. It turns out a kind
Where does it come from
inflammation in the bile
bubble if there is no
stones? It can be
bladder bacteria from the intestines,
there “against the move”
bile, in the gallbladder
duct. This is normal
that is, a muscle “lock”,
but many people
he weakens and cannot
About the possibility of such
ways of origin
in your situation
also says the presence
which has evolved,
most likely for the same
mechanism. Bloating intestines
in this case
is also one of
manifestations of chronic
in the intestines, biliary
pathways and pancreas
kink of the gallbladder,
then fix the inflection itself
means, most likely
will not work.but
you can try to reduce
unpleasant manifestations of this state.
For example, take
medicines that will
these include drugs
drugs with ursodeoxycholic
choleretic collection No. 3
or the same holosas syrup.
normalization of outflow
bile is adherence
diet. To eat
need in small portions,
but often enough,
5-6 times a day, preferably
in the same
time is your body
get used to the fact that
bile needs to be secreted to
a certain time
and will do it over
food should be sparing
for the intestines, then
have passed thermal
processing. For example,
cooking, cooking on
steaming, stewing, but not frying.
Should give up
foods high in
meat and fish, strong
broths, smoked meats), and
also from products that promote
intestines (sweets, white
bread, baked goods). Should
also limit use
products (for example,
sour cream and cream), eggs.
It is advisable to drink more
liquids are best
plain pure water
(not compotes and juices), up to
one and a half liters per day.Must be consumed
in sufficient quantity
dietary fiber that
bile from the gallbladder.
A large number of
dietary fiber contains
in vegetables (preferably
(brew a couple of tablespoons
boiling water and eat
in the morning instead of porridge) or
for example, mukofalk
or phytomucil. The same
dietary fiber will help
bacteria in the intestine and
This will also be
that is, drugs
normally in large quantities
and help to digest
food. Available now
a large number of different
To monitor the status
glands, regularly enough
carry out the usual
It’s pretty efficient
and inexpensive method
diagnostics. In some
cases the doctor may prescribe
carried out using
or trial: they help
identify various violations
activity of the gallbladder,
its duct and sphincter.
90,000 with and without him “
Etude of Dr. Ivanov on the gastrointestinal tract: on gallstone disease and cleansing the liver according to Malakhov. Part 4
In previous articles on digestion, the candidate of medical sciences, osteopath Alexander Ivanov spoke in detail about various diseases – gastritis, flatulence, constipation, etc. stones and other diseases, about tubing and massage of internal organs.
A FEW WORDS ABOUT THE LIVER
The liver is the biochemical laboratory of our body. One of its important functions is detoxification, that is, neutralizing toxins (substances foreign to us) – hormones, antibiotics, drugs, alcohol, heavy metals that enter our body from the external environment (food, water, air). In addition, the liver is involved in digestion, producing bile, as well as in almost all types of metabolism (protein, fat, carbohydrate, mineral).
It is no coincidence that in many traditional healing systems (for example, in Ayurveda and Chinese medicine), the liver is assigned the main role in maintaining human health. Thus, the role of the liver can hardly be overestimated.
GALL BLADDER – A FAITHFUL FRIEND AND LIVER ASSISTANT
The gallbladder is a faithful friend and helper of the liver. The latter can produce up to 600 ml of bile per day, and the gallbladder, which is a bag with a volume of 70 – 80 ml, essentially stores this bile.
During fasting, the gallbladder is able to absorb (suck) up to 90% of the liquid component of bile, concentrating and preserving it. Eating food stimulates the gallbladder, and bile begins to flow into the lumen of the duodenum (part of the small intestine), participating in digestion.
HIPPOCRATES ABOUT BILD, OR WHY DO WE NEED BILD?
Bile is produced by the liver and is, on the one hand, an emulsifier (solvent) of fats, and on the other, that cleansing medium with which the liver and our body get rid of substances we do not need – toxins (cholesterol, antibiotics, heavy metals, hormones, alcohol ).
In terms of chemical composition, bile consists mainly of water and electrolytes (salt), as well as organic substances (cholesterol, bilirubin, bile salts).
Even Hippocrates spoke of bile as one of the forms of the internal environment of the body. He introduced the idea of a person’s temperaments and concluded that if a person has a lot of bile, then he is prone to irritability, irascibility and anger. No wonder there is such an expression as “bilious man.” Such “bile” people are prone to heart disease and blood vessels, hypertension, strokes and heart attacks.He attributed this type of people to choleric people. With an excessive amount of “black” bile, a person is prone to apathy, depression, fears, which corresponded to a melancholic temperament.
Today, the ideas of Hippocrates, to put it mildly, are outdated, and today a person’s temperament (a type of higher nervous activity) is not determined by bile. However, from the point of view of psychosomatics, there is a grain of truth in his observations.
STONES IN GALL BLADDER
The appearance in the gallbladder of dense formations of stones is called gallstone disease, or calculous cholecystitis.The diagnosis is made on the basis of ultrasound data. Symptoms of calculous cholecystitis: dull, aching pain in the right hypochondrium of a constant nature or arising one to three hours after eating, most often fatty, fried or smoked, while there may be a bitter taste in the mouth or a metallic taste, belching, bloating, upset stool, insomnia and irritability. Treatment of calculous cholecystitis is usually surgical. But in some cases, the treatment can be conservative – medication.For example, with small cholesterol stones, the tactic of dissolving stones with the help of bile acid preparations is used, as well as fragmentation of stones – a method of extracorporeal shock wave therapy.
GALL STONE DISEASE: WHEN TO DO THE OPERATION?
The operation to remove the gallbladder is called cholecystectomy. Previously, before the advent of endoscopic surgery, the gallbladder was removed, leaving rough abdominal scars and adhesions. At the moment, operations are less traumatic, there are only small punctures that are barely visible on the skin.
Can a person live without a gallbladder? Yes, it can, but there is nothing superfluous in the body, and the removal of the gallbladder is always a tragedy for the whole body. After surgery, dyspepsia, upset stools such as constipation or diarrhea may often appear. The pancreas and liver begin to suffer.
Among some doctors there is an opinion that if stones in the gallbladder are found, then the operation must be done, as they say, just in case of fire. However, in the Western medical literature on this issue, they say that if calculi are less than 3 cm in diameter and there are no clinical manifestations (pain), then it is not worth removing the gallbladder.Indications for removal of the gallbladder are attacks of hepatic colic (the risk of blockage of the bile ducts by a stone) and large stones (more than 3 cm) – this condition increases the risk of developing gallbladder carcinoma.
CAUSES OF CHILIAR STONE DISEASE
Gallstone disease is more common in women than in men, as estrogens (female sex hormones) play an important role here. A sedentary lifestyle (sedentary work), a violation of the diet (abuse of fatty and fried), irregular nutrition (long breaks between meals and prolonged fasting), burdened heredity – all these are risk factors for cholecystitis.
Dyskinesia (literally “movement disorder”) of the biliary tract is a violation of the outflow of bile along the biliary tract. It can be hyperkinetic (excessive tension, spasm) and hypotonic (on the contrary, contractile weakness of the gallbladder). Dyskinesia occurs most often due to a spasm of the sphincter of Oddi (the place where the bile duct flows into the intestine), with kinks of the gallbladder or in violation of the diet.The most common cause of sphincter spasm is chronic stress. Dyskinesia can be the cause of gallstones – gallstones.
Most often this disease occurs in young children due to the imperfection of their digestive system. The manifestations of dyskinesia can be abdominal pain, colic, pain in the right hypochondrium, yellow coating on the tongue, bitterness in the mouth.
In case of dyskinesia, the doctor may prescribe a fractional diet 5 – 6 times a day, choleretic drugs, antispasmodics or abdominal massage.Manual medicine methods, such as osteopathic techniques, are effective and safe.
TUBAGE STRAIGHT AND INDIRECT
In medical practice, there are methods of artificial drainage (removal) of bile from the gallbladder. Medical tubage (from the French word tubage “washing”) is a therapeutic and prophylactic measure aimed at removing bile from the gallbladder using choleretic agents. It can be performed using a duodenal probe (direct tubing) or without it (indirect tubing).This method is used for biliary dyskinesia, acalculous cholecystitis, inflammation of the pancreas (pancreatitis) and duodenal ulcers (duodenitis). Many sanatoriums still use this method, which is very effective for diseases of the gastrointestinal tract.
LIVER CLEANING ACCORDING TO MALAKHOV
I would like to warn dear reader against different liver cleanses according to recipes from the Internet or books of “folk healers” such as Gennady Malakhov and Andreas Morritz .Also now very popular “enema”, where for decent money you will be starved, stuffed with laxatives, do daily enemas and carry out a la tubage. All this is called cleansing the body. For me, this is complete obscurantism. I have nothing against alternative methods of treatment, but I am for a reasonable approach to each person. The methods of Ayurveda, therapeutic fasting, unloading and dietary therapy have a place to be, but only under strict medical supervision and in the hands of professionals.
MASSAGE OF THE INTERNAL ORGANS, OR HOW CAN OSTEOPATHY HELP IN DYSKINESIA?
In the arsenal of modern medicine there are safe, but effective methods of eliminating functional problems – dysfunctions of internal organs, including the gallbladder. An osteopathic doctor, with the help of his sensitive hands, will diagnose and identify areas of restriction and tension of internal organs. With the help of his hands, the doctor will delicately relieve the spasm, drain the bile and restore the work of the gastrointestinal tract.Such gentle osteopathic techniques are suitable for both young children and adults with gallbladder problems. The duration of a session with an osteopathic doctor takes no more than one hour, the frequency is on average one session per week. The course of treatment can last a month.
1. The liver produces bile and stores it in the gallbladder. At the time of eating, bile is secreted into the intestines and breaks down fats.
2. The gallbladder is an important organ, without which our body begins to ache.
3. The formation of stones in the gallbladder is not always an indication for surgery.
4. Regular and balanced nutrition, regular physical activity and drainage of the biliary system are effective measures to prevent gallstone disease.
5. Tyubage (direct and indirect) is a medical procedure, and it is not safe to carry out it yourself at home.
6. Cleansing the liver using folk methods is often harmful to health.
7.Dyskinesia (impaired outflow of bile) is of a functional (emotional) nature and is usually associated with spasm of the muscular sphincter. Manual treatments such as osteopathy are effective in treating dyskinesia.
The opinion of the author may not coincide with the position of the editorial office
What you need to know about ultrasound of the gallbladder: indications, decoding
Ultrasound examination of the gallbladder is part of the general examination of the abdominal cavity.The most common indication for it is the suspicion of gallstone disease. In addition to stones in the gallbladder, ultrasound also detects polyps, specifies their number and localization, and also reveals signs of cholecystitis. If you need to undergo an ultrasound scan in Simferopol, contact our medical center.
Explanation of ultrasound of the gallbladder
In the results of the study, you can find the following concepts:
- Deposits (calculi). These are stones, most often they consist of cholesterol, calcium ions and bile pigments.The effect of deposits on the state of the body depends primarily on their size and quantity. The more deposits, the higher the risk of blockage of the cystic duct or common bile duct, which can lead to the development of acute cholecystitis and even acute pancreatitis.
- Diffuse thickening of the gallbladder wall. The most common cause of this is cholecystitis. Less common causes are circulatory failure, renal failure, and sepsis.
- Focal thickening of the gallbladder wall.The thickening affects only part of the wall. Most often, it indicates the presence of a polyp, tumor (possibly malignant) and adenomyomatosis.
- Presence of many very small deposits. They appear as “dirt” on ultrasound images. This indicates a malfunction of the gallbladder, including a chronic inflammatory process.
- Dilated bile ducts. The intrahepatic and extrahepatic bile ducts may be dilated. The main causes include: gallstone disease, chronic inflammation of the bile ducts and neoplasms.
- Porcelain gallbladder. This means that its walls are highly saturated with calcium salts (calcified). Having a porcelain bladder increases your risk of developing gallbladder cancer, which has a very poor prognosis.
- Ultrasound Murphy’s symptom. A positive symptom indicates acute cholecystitis or cholecystolithiasis, a negative symptom requires the diagnosis of acute cholangitis or cholelithiasis.
However, it is not worthwhile to interpret the examination results on your own, for this you need to consult a doctor.