Gallbladder: Image, Definition, Problems, Tests & Function

The gallbladder is an organ that looks like an elongated pear and can hold anywhere between 30 and 50 millilitres of fluid. Because of its muscular contractions, it not only stores the bile but also concentrates it, and then it releases the bile into the duodenum.

Bile juice is beneficial for the digestion of lipids. It not only includes bile salts but also bile pigments, such as biliverdin and bilirubin. In some cases, the gallbladder must be removed, however, this does not change or improve the situation.Radio opaque substances, which are passed out of the body in the bile, are also concentrated in the bile. So, they are used in the process of cholecystography, which uses x-rays to show the gallbladder's cavity as well as its ability to contract and concentrate.

The main functions of the gallbladder are:

• Storage of bile: The gallbladder stores and concentrates bile produced by the liver, which helps the body digest fats easily.
• Gallbladder releases bile: When we eat, especially a meal high in fats, the gallbladder releases bile into the small intestine to emulsify the fats, making them easier to absorb by the body.
• Regulating bile flow: The gallbladder regulates the flow of bile into the small intestine by contracting or relaxing its muscles, to release bile in a controlled manner.
• Bile pH regulation: The gallbladder also plays a role in regulating the pH of bile. Bile can become too acidic, which may cause the formation of gallstones.
• Absorption of certain vitamins in our body: The gallbladder also helps absorb fat-soluble vitamins such as Vitamin K and Vitamin A from the small intestine.

• Gallstones (cholelithiasis): Crystallisation of chemicals that are already present in bile may happen infrequently, but the reasons why this occurs are not completely understood or recognised at this time. They become crystalline and develop into gallstones or gallbladder stones. Even though gallstones are very common and rarely cause any symptoms, they can sometimes be painful, make you feel sick, or cause inflammation.
• Cholecystitis: infection of the gallbladder may lead to the production of gallstones, which can be very painful and cause fever. When the infection persists or returns, surgical intervention is required in such severe instances.
• Cancer of the gallbladder: Cancer may affect the gallbladder, despite the fact that the risk is minimal or perhaps nonexistent. In most cases, a diagnosis is not made during the early stages of the condition; rather, it is made at a later stage when symptoms become apparent. The symptoms are quite similar to those that are caused by gallstones.
• Gilbert: Gilbert syndrome is a genetic disorder that is often found to be present by chance, such as when a person goes in for a routine blood test. This condition is brought on by a malfunction in the way that the liver processes bilirubin.
• Choledocolithiasis: Stones may develop in the common bile duct when this disease is present. This condition is known as cholelithiasis.
• Cholangitis: Cholangitis is an illness that affects the bile ducts, which are the tubes that transport bile from the gallbladder and intestines to the liver. The liver is responsible for producing the juice known as bile, which is then used to digest meals.
• Gallstone ileus: When a stone travels through an enteric fistula, it may get lodged there, causing intermittent obstructive symptoms in the ileum. Some of these symptoms are nausea and throwing up, and they can eventually cause the small intestine to get blocked.
• Biliary Cysts: When there is cystic dilatation of the biliary tree, it causes the formation of biliary cysts. There are those linked to cholangiocarcinoma, rupture, stricture, cholangitis, and other conditions.
• Cholangiocarcinoma: when there is adenocarcinoma starting from anywhere but within the biliary tree, that is outside of the gallbladder or ampulla. Primary sclerosing cholangitis, cystic liver/biliary disease, parasite infection, and chronic liver disease such as intrahepatic cholangiocarcinoma are all risk factors.It can also cause jaundice, RUQ pain, and systemic signs like weight loss and fever.
• Gallbladder Cancer: It is a cancer of the gallbladder called adenocarcinoma. Those who suffer from chronic inflammation of the gallbladder, such as gallstones, chronic infection, or biliary cysts, are at a much increased risk. Jaundice, biliary colic, weight loss, and RUQ mass may be symptoms of biliary obstruction, which can sometimes present with a generic or ambiguous presentation.
• Gallstone pancreatitis: Because of the presence of impacted gallstones, there is a blocking of the ducts that drain bile juice to the pancreas, which causes inflammation of the pancreas. This is a serious problem because the pancreas is in charge of making many digestive enzymes, most of which help with digestion.
• Crigler-Najjar syndrome: The Crigler-Najjar syndrome is a very unusual genetic condition that is characterised by an inability to properly convert bilirubin and clear it from the body. This condition is extremely rare. The yellowing of the skin, mucous membranes, and whites of the eyes can become severe and pervasive in infants who are affected by this condition over time (jaundice). Even after the first three weeks of life, these symptoms are still present.
• Dubin-Johnson syndrome: This condition, which is also called Dubin-Johnson syndrome (DJS), is a genetic disorder that is harmless and can affect the liver. One of the main signs of this condition, which is passed down in a way called autosomal recessive inheritance, is the buildup of bilirubin, a substance that the liver normally gets rid of through the bile. DJS is caused by a change in the gene that affects the transporter protein that moves bilirubin, a normal byproduct of red blood cell breakdown, into the bile. After that, the bile leaves the body through the stoma.
• Rotor syndrome: Rotor syndrome is an autosomal recessive disease that is caused when biallelic inactivating mutations in SLCO1B1 and SLCO1B3 cause both OATP1B1 and OATP1B proteins to not function properly. This causes the disease to be passed down from one generation to the next. It is important to know that some changes can make it more likely that a medicine will have unwanted side effects.
• Primary Biliary Cholangitis: Primary biliary cholangitis is an ongoing illness that causes the gradual degradation and eventual loss of the microscopic bile ducts that are found in the liver. The medical term for this ailment is primary biliary cholangitis. When bile builds up in the liver because there are no bile ducts to evacuate it, the liver becomes damaged.
• Cholangitis: Inflammation (swelling) of the bile duct is the medical definition of cholangitis. caused by a gallbladder or other infection.
• Gallstone ileus: it is a disease which evolves when a stone in the ileum obstructs the bowel passage.
• Biliary colic: the contraction of smooth muscle in the wall of the gallbladder, which occurs when the gallstone is trying to be expelled, is the typical cause of this condition. It is episodic and is at its worst when a stone (calculus) is impacted either at the terminal end of the cystic duct or at the lower end of the bile duct.
• Obstruction of CBD: The obstruction of CBD is typically caused by gallstones, pancreatic carcinoma, or enlarged neoplastic hepatic lymph nodes. In rare cases, it can also be caused by cancer of the pancreas. Because it blocks the flow of bile, it makes the person get jaundice.

• Abdominal ultrasound: An innocuous probe is put on the patient's skin, and high-frequency sound waves are used to reflect off of various anatomical structures in the abdomen. The USG test is considered to be the gold standard for both the diagnosis of gallstones and the examination of the gallbladder wall.
• HIDA scan (cholescintigraphy): A radioactive dye is injected intravenously as part of this nuclear medicine test. The radioactive dye is then excreted in the bile. Cholecystitis is highly likely to occur if the scan reveals that bile does not travel from the liver to the gallbladder.
• Endoscopic retrograde cholangiopancreatography (ERCP) for cholecystitis: During this procedure, a catheter is inserted into the hepatopancreatic ampulla. After that, radiopaque contrast medium is injected, and the bile and pancreatic ducts are visualised. This procedure is performed under direct vision through a fiber-optic endoscope. In the event that ERCP is unsuccessful, a radiological procedure known as percutaneous transhepatic cholangiography is used to visualise the biliary tract.
• Magnetic resonance cholangiopancreatography (MRCP): A high-resolution image of the bile ducts, pancreas, and gallbladder can be obtained through the use of an MRI scanner. The images obtained from the MRCP help guide subsequent diagnostic procedures and treatments..
• Endoscopic ultrasound: After making an incision in the patient's mouth, a thin ultrasound probe that is attached to the end of a flexible tube is then inserted into the patient's intestines. Choledocholithiasis and gallstone pancreatitis are both conditions that can be diagnosed with the assistance of endoscopic ultrasound.
• Abdominal X-ray: In most cases, X-rays are unable to correctly diagnose gallbladder disease. However, X-rays can be helpful in locating other abdominal problems. On the other hand, gallstones might be visible on an X-ray.
• Cholecystography: The gallbladder itself is not opaque to X-rays; however, when certain radiopaque dyes are administered, either orally or intravenously, the dyes are excreted by the liver from the blood into the bile, which then travels to the gallbladder. Because of the dye's increased concentration in the gallbladder, this organ appears opaque when examined by X-rays

• Gallbladder surgery (cholecystectomy): A surgeon removes the gallbladder, using either laparoscopy (several small cuts) or laparotomy (traditional “open” surgery with a larger incision).
• Chemotherapy and radiation therapy for gallbladder cancer: After surgery for gallbladder cancer, chemotherapy and radiation may be used to help prevent cancer from returning.
• Extracorporeal shock-wave lithotripsy for cholelithiasis: High-energy shockwaves are projected from a machine through the abdominal wall, breaking up gallstones. Lithotripsy works best if only a few small gallstones are present.
• Contact solvent dissolution: A needle is inserted through the skin into the gallbladder, and chemicals are injected that dissolve gallstones. This technique is rarely used.
• Percutaneous cholecystostomy: Percutaneous cholecystostomy (PC) is used to treat gallbladder diseases such as cholecystitis or cholangitis, malignant or benign biliary blockage, gallbladder perforation, and percutaneous biliary stone removal.
• Endoscopic sphincterotomy: Biliary endoscopic sphincterotomy (EST) is the cutting of the biliary sphincter and intraduodenal portion of the common bile duct after selective cannulation with a high frequency current administered with a sphincterotome introduced into the papilla.
• Enterolithotomy: The goal of gallstone ileus therapy is to remove the blockage by enterolithotomy. Because it has a lower morbidity and mortality rate than the other procedures, it is the preferred treatment for gallstone ileus care.
• Hepaticojejunostomy: The hepatic duct is a tubular conduit that transports bile from the liver to the small intestine. A hepaticojejunostomy is a surgical technique that creates an anastomosis (connection) between the hepatic duct and the jejunum, the middle region of the small intestine.

• Ursodeoxycholic acid for gall stone: It helps in dissolution of the gallbladder stone as it decreases small cholesterol gallstones and reduce the symptoms of it it is helpful in both oral tablets and syrup solutions comes in the market from variety of pharmaceutical companies
• Antibiotics for cholecystitis: Antibiotics, in combination with other treatments, may be used to treat an infection caused by H. pylori. During treatment, the antibiotics are given to the stomach in an effort to heal the damage caused by the infection. Some of the examples include metronidazole ceftriaxone and sulphabactum
• Antiparasitic drugs for cholecystictis: In the treatment of parasites, some examples include metronidazole, praziquantel, and albendazole. In the treatment of bacterial infections, some examples include azithromycin, ciprofloxacin, and tetracycline.
• Antiviral Medications for cholecystictis: A number of antiviral drugs, such as entecavir, tenofovir , lamivudine , adefovir , and telbivudine, can aid in the fight against the virus and lessen its ability to harm your gall bladder.
• Hepatic Rejuvenation Medicine: including n-acetyl cysteine, trypsin, and vitamin K, are used as adjuvant therapy for the treatment of a wide range of hepatocellular diseases.
• Chemotherapeutic Drugs for gall bladder carcinoma: Chemotherapy and radiation are effective treatments for gall bladder cancer, despite the disease's untreatable nature. In extreme cases, the gall bladder may be removed surgically or replaced with a donor organ.
• Statins for cholelithiasis: This class of drugs is known as lipid-lowering medicines, and it has other beneficial properties for slowing the development of acute or chronic gall bladder disease, such as lowering oxidative stress and inflammation. Rosuvastatin, atorvastatin, etc., are all instances of statins.
• Corticosteroids for cholecystictis: Drugs with anti-inflammatory properties work by preventing the recruitment of polymorphonuclear leukocytes (PMNs) to areas of cellular and tissue injury, hence reducing inflammation. Methylprednisolone is an example of an effective corticosteroid.