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Encyclopedia > Gall bladder
Digestive system diagram showing the bile duct

The gallbladder (or cholecyst) is a pear-shaped organ that stores bile (or "gall") until the body needs it for digestion. It is connected to the liver and the duodenum by the biliary tract.

Contents

Anatomy

Not all mammals have gallbladders. The rat and horse, for example, do not have a specialised organ for the storage of bile. The gallbladder is connected to the main bile duct through the gallbladder duct (cystic duct or, in Latin, ductus cysticus). The main biliary tract runs from the liver to the duodenum, and the cystic duct is effectively a "cul de sac", serving as entrance and exit to the gallbladder. The surface marking of the gallbladder is the intersection of the mid-clavicular line (MCL) and the transpyloric plane, or the tip of the ninth rib. The blood supply is by the cystic artery and vein, which run parallel to the cystic duct.


Microscopic anatomy

The gallbladder has an epithelial lining characterised by recesses (called Aschoff's recesses), which are pouches inside the lining. Under the epithelium there is a layer of connective tissue, followed by a muscular wall that contracts in response to cholecystokinin.


Function

The gallbladder stores bile, which is released when fat-containing food enters the digestive tract, stimulating the secretion of cholecystokinin (CCK).


Role in disease

Cholestasis

Cholestasis is the blockage in the supply of bile into the digestive tract. It can be "intrahepatic" (the obstruction is in the liver) or "extrahepatic" (outside the liver). It can lead to jaundice, and is identified by the presence of elevated bilirubin level that is mainly conjugated.


Cholelithiasis

Enlarge
Cholecystectomy seen through a laparoscope

Up to 25% of all people have gallstones (cholelithiasis), composed of cholesterol, lecithin and bile acids. These can cause colicky shooting abdominal pain, usually in relation with the meal, as the gallbladder contracts and gallstones pass through the bile duct. Surgery (cholecystectomy, removal of the gallbladder) is the most common treatment for gallstones. It can be performed laparoscopically, and it is in fact one of the most common procedures done through the laparoscope.


People traditionally considered at an increased risk of cholelithiasis are people who are 5 F's:

Cholecystitis

Please refer to main article: Cholecystitis


Acute or chronic inflammation of the gall bladder causes abdominal pain. 90% of acute cholecystitis are caused by the presence of gallstones.


Choledocholithiasis

When gallstones obstruct the common bile duct, the patient develops jaundice and liver cell damage. It is a medical emergency, requiring endoscopic or surgical treatment.


Gallstone ileus

A rare clinical entity is ileus (bowel obstruction) by a large gallstone, or gallstone ileus. This condition develops in patients with longstanding gallstone disease, in which the gallbladder forms a fistula with the digestive tract. Large stones pass into the bowel, and generally block the gut at the level of Treitz' ligament or Bauhin's valve, two narrow points in the digestive tract. Therapy is surgical.


Gallbladder cancer

Gallbladder cancer is a rare but serious form of cancer. On biopsy, it is usually an adenocarcinoma. It shows on X-ray as a "porcelain gallbladder". The prognosis is poor.


Courvoisier's law

Couroisier's law states that "the gallbladder is more often enlarged in malignancy than in gall stone disease". Courvoisier's sign is an enlarged, non-tender gallbladder together with jaundice; it is a sign of pancreatic carcinoma, in which the bile duct is obstructed and bile accumulates in the gallbladder.


External links


Digestive system

Mouth - Pharynx - Esophagus - Stomach - Pancreas - Gallbladder - Liver - Small intestine (duodenum, jejunum, ileum) - Colon - Cecum - Rectum - Anus


  Results from FactBites:
 
gall bladder. The Columbia Encyclopedia, Sixth Edition. 2001-05 (239 words)
When food containing fat reaches the small intestine, the hormone cholecystokinin is produced by cells in the intestinal wall and carried to the gall bladder via the bloodstream.
The hormone causes the gall bladder to contract, forcing bile into the common bile duct.
They can cause inflammation of the gall bladder, a disorder that produces symptoms similar to those of indigestion, especially after a fatty meal is consumed.
Gall Bladder Gallbladder Symptoms Surgery (1058 words)
Symptoms of gall stones or signs and symptoms of gall bladder attacks, are the result of a gall stone obstructing the cystic duct.
Gall bladder cancer is rare in the United States, affecting approximately only 1% of the population.
The gall bladder is a fairly simple organ (holding sack) which stores bile that trickles from your liver until it is needed for fat digestion.
  More results at FactBites »

 
 

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