Biliary vesicular

Gallbladder, an organ used as a reservoir for bile, present in most vertebrates.

The gallbladder is a membranous sac in the shape of a pear, situated beneath the right lobe of the liver, at the height of the ninth or tenth rib. It is about 7.5 cm long and, in its widest part, 2.5 cm in diameter. Its capacity varies from 30 to 50 ml.

The gallbladder is disposed obliquely towards the back and left of the abdomen. It is composed of an enlarged base, then a body (the main part), which gradually narrows to the neck (or pelvis), which terminates in the cystic duct. The latter joins the hepatic duct (which contains the bile from the liver) to form the bile duct, which flows into the small intestine. When the vesicle is too large, the bottom slightly protrudes beyond the anterior margin of the liver, and may be felt by the doctor.

The wall of the gall bladder has a thin serous membrane (of peritoneal origin), an average layer of fibrous tissue and smooth muscle, and an internal layer of mucous membrane.

Between the meals the gall bladder concentrates and stores the bile secreted by the liver, which passes through the liver and cystic ducts, and absorbs the water and the electrolytes. During meals, following the arrival of lipids in the duodenum, the vesicle discharges the bile it contains by two mechanisms, one reflex nerve and the other hormonal. The role of bile is to cause the emulsion of dietary fat, so that the latter can be absorbed through the intestinal mucosa and pass into the bloodstream.

DYSFUNCTIONS

Biliary lithiasis

The gallbladder may be the seat of a lithiasis, forming calculi, stony concretions sometimes reaching the size of a small pear. After duodenal ulcer, biliary lithiasis is the most common chronic gastrointestinal disorder in industrialized countries. Being formed from the salts that make up the bile, the calculations are usually made of cholesterol, but sometimes also calcium, as well as a pigment characteristic of bile, bilirubin.

The development of calculations seems to be due to two mechanisms:

  • the presence in the bile of excessive amounts of the constitutive substances of the calculations,
  • the retention of the bile in the vesicle for a long period. Women and the elderly are more prone to gallstones than the rest of the population.

In some cases, lithiasis (often asymptomatic) may be complicated by hepatic colic: this is the migration of a calculation to the bile duct, resulting in sudden and severe pain at the top and right of the abdomen.

Cholecystitis

Another possible complication is acute cholecystitis (acute inflammation of the gall bladder).

It's also a common disorder. Depending on the severity of the attack, it is called chronic or acute. Acute cholecystitis is usually the complication of a lithiasis. It results in pain associated with fever and may evolve into peritonitis.

Tumors

There are also benign tumors and cancers of the gall bladder.

Cancer of the gall bladder causes symptoms only at an advanced stage ie when the tumor has begun to spread to neighboring organs (liver ...). Here is a list of symptoms found in the most cases:

  • Quick Weight Loss
  • Vomiting
  • Possible jaundice

TREATMENT

In general, calculations of the vesicle do not pose particular problems and do not require treatment. However, if the lithiasis has already given rise to symptoms and complications, or if a calculation is too large, surgical removal of the vesicle (cholecystectomy) can be performed.

In patients who can not be operated on, the calculations can be dissolved by a natural bile salt administered orally. The use of surgery can also be avoided, if there is no complication in progress, by a method of disintegration of calculations without penetration of instruments into the body, called lithotripsy (or lithotripsy) extracorporeal.

In this case, an apparatus is used which sends different types of waves (electromagnetic, for example) intended to spray the calculation.

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