The gall bladder is a pear-shaped or conical hollow organ that is located on the surface of the liver, between its square and right lobes. The main function of the gallbladder is the accumulation and concentration of bile, as well as its periodic “sending” through the common and cystic ducts to the duodenum.
In different people, the gallbladder has different sizes, its length varies from 5 to 13-14 centimeters, its width is from 2 to 4 centimeters, and its capacity is 30-70 ml. In the presence of pathological conditions, these parameters can vary significantly. In the structure of the gallbladder, the body, the bottom and the neck, passing into the cystic duct, are distinguished. The walls consist of three types of membranes: muscle, mucous and connective. The lower surface of the gallbladder is covered by the serous membrane. The mucous membrane consists of many folds, one of which, located in the neck and called the Geister valve, forms the Lutkens sphincter together with muscle fibers. In the connective tissue membrane and between the muscle fibers are tubular channels that do not communicate with the cavity of the bladder, they are called Lushka moves.
The liver and gall bladder are located in the right hypochondrium, however, the location of the gall bladder may vary somewhat, since it depends on the physique and age. Blood supply to the gallbladder comes from the gallbladder artery, which, as a rule, departs from the right branch of the hepatic artery, the veins are multiple and form from the venous plexus, flow into the branches of the portal vein located inside the liver.
After eating, the gallbladder contracts, and at the same time, pressure rises in it, which can be 200-300 mm of water. After that, concentrated bile enters the common bile duct. Its more intensive intake is observed after eating egg yolks, animal and vegetable fats. Contraction of the gallbladder is replaced by relaxation and filling it with hepatic bile. The highest intensity of this process is observed at night.
Pathological conditions and diseases of the gallbladder are characterized by pain in the right hypochondrium, sometimes in the epigastric region with concomitant irradiation to the collarbone, shoulder joint and right shoulder blade. The appearance and intensification of pain is observed after eating spicy and fatty foods, eggs, fried foods, beer, wine, carbonated drinks, as well as after lifting weights and physical exertion, with shaking while driving and mental stress. However, with cholelithiasis , spontaneous, for no apparent reason, pain can occur. With dyskinesia of the gallbladder, a typical pain syndrome is accompanied by a vegetative crisis, the signs of which are cold sweat, numbness of the extremities, pallor of the skin, headache, etc. Very often, these diseases occur with belching, nausea, bitterness in the mouth, etc.
In acute inflammatory processes of the gallbladder, palpation in the right hypochondrium is sharply painful. The pain intensifying during inhalation is called the Kera symptom, while sitting, the Murphy symptom, severe soreness with weak tapping along the right costal arch, the Ortner symptom. Symptoms of irritation of the abdominal cavity also occur in the case of peritonitis. In the presence of chronic inflammation, the gallbladder does not make itself felt upon palpation in the right hypochondrium, as well as in pain points, and there are no symptoms of cholecystitis.
The following malformations of the gallbladder are distinguished: aplasia - its absence, hypoplasia - a decrease in its size, atresia - the absence of a cavity, doubling, dystopia. In addition, there are various developmental abnormalities (for example, an inflected gallbladder) that are asymptomatic or with a clinical presentation of gallstone disease or chronic cholecystitis.