Gallbladder Disease: Overview, Types & Diagnosis. The term “gallbladder disease” is used for several types of conditions that can affect your gallbladder. ![]() ![]() The gallbladder is a small pear- shaped sac located underneath your liver. Your gallbladder’s main function is to store the bile produced by your liver and pass it along to the small intestine. Bile helps you digest fats in your small intestine. The majority of gallbladder diseases are caused by inflammation due to irritation of the gallbladder wall, which is known as cholecystitis. This inflammation is often due to gallstones blocking the ducts leading to the small intestine and causing bile to build up. It may eventually lead to necrosis (tissue destruction) or gangrene. Other diseases of the gallbladder include gallbladder polyps and gallbladder cancer. Gallstones. Gallstones develop when substances in the bile (such as cholesterol, bile salts, and calcium) form hard particles that block the passageway to the gallbladder. Gallstones also tend to form when the gallbladder doesn’t empty completely or often enough. They can be as small as a grain of sand or as large as a golf ball. Numerous factors contribute to your risk of gallstones. These include: being overweight or obeseeating a high- fat or high- cholesterol diethaving diabetesbeing age 6. Cholecystitis. Cholecystitis is the most common type of gallbladder disease. It presents itself as either an acute or chronic inflammation of the gallbladder. Acute Cholecystitis. Acute cholecystitis is generally caused by gallstones, but it may also be the result of tumors or various other illnesses. It may present with pain in the upper right side or upper middle part of the abdomen. The pain tends to occur right after a meal and ranges from sharp pangs to dull aches that can radiate to your right shoulder. Acute cholecystitis can also cause: fever nausea vomitingjaundicedifferent colored stools. Chronic Cholecystitis. ![]() ![]() After several attacks of acute cholecystitis, the gallbladder will shrink and lose its ability to store and release bile. Abdominal pain, nausea, and vomiting may occur. Choledocholithiasis. Gallstones may become lodged in the neck of the gallbladder or in the bile ducts. When the gallbladder is plugged in this way, bile can’t exit. This may lead to the gallbladder becoming inflamed or distended. The plugged bile ducts will further prevent bile from traveling from the liver to the intestines. Choledocholithiasis can cause: extreme pain in the middle of your upper abdomenfeverchillsnauseavomiting. Acalculous Gallbladder Disease. Acalculous gallbladder disease, or biliary dyskinesia, occurs without the presence of gallstones. It can be chronic or acute and may result from the gallbladder muscles or valve not working properly. The symptoms can include abdominal pain on the right side of your body that radiates to your shoulder. Eating foods high in fat often triggers this. Related symptoms may include: nauseavomitingbloatingloose stools. Sclerosing Cholangitis. Inflammation, scarring, and damage to the bile ducts is referred to as sclerosing cholangitis. It’s unknown what causes the disease. People with sclerosing cholangitis may have an enlarged liver or spleen along with a decrease in appetite and weight loss. How to Identify Gallbladder Disease. The gallbladder is a small digestive organ whose primary function is to store bile created by the liver. Sometimes the. Full Stomach, Gallbladder and Pancreas Description . Anatomy of the Stomach, Gallbladder, and Pancreas. Stomach A hollow muscular organ. Gallbladder Cancer. Cancer of the gallbladder is a relatively rare disease. If it’s not treated, however, it can spread from the inner walls of the gallbladder to the outer layers and then to the other organs and ducts. The symptoms of gallbladder cancer may be similar to those of acute cholecystitis. Gallbladder Polyps. ![]() Gallbladder polyps are lesions or growths that occur on the gallbladder. They’re usually benign and have no symptoms. Gangrene of the Gallbladder. Gangrene develops when the gallbladder stops functioning due to inadequate blood flow. This may occur due to: infectionsinjurydiabetessurgerydiseases related to blood circulation. The symptoms of gallbladder gangrene can include: pain in the gallbladder regionfevernausea or vomitinggasdisorientationlow blood pressure. Abscess of the Gallbladder. Abscess of the gallbladder results when an area of the body becomes inflamed with pus. Pus is the accumulation of white blood cells, dead tissue, and bacteria. It may present with upper right- sided pain in the abdomen. Neck Pain Explained - Neck pain, diagnosis, herniated disc, arm pain, surgery and artificial discs. Gallstones are concretions that form in the biliary tract, usually in the gallbladder (see the. The term “gallbladder disease” refers to several types of conditions that can affect your gallbladder. Read about gallbladder cancer symptoms. Although early signs of gallbladder cancer may not be present, some people may experience abdominal pain or jaundice. Pain in the left side could be caused by a wide variety of things including disease, injury or simple overexertion. The cause of this kind of pain is dependent on. ![]() To diagnose gallbladder disease, your doctor will ask you about your medical history and perform an abdominal exam. This will include checking for pain in the abdomen. One or more of the following tests and procedures may be used: Detailed Patient History. A list of symptoms being experienced and any personal or family history of gallbladder disease are important. A general health assessment may also be performed to determine if there are any signs of a long- term gallbladder disease. Physical Exam. Your doctor may perform a special maneuver during the abdominal exam to look for what is referred to as “Murphy’s sign.” During this maneuver, your doctor will put their hand on your abdomen to feel the gallbladder, and then ask you take a breath while palpating near the gallbladder. If you feel severe pain, it suggests you may have gallbladder disease. Chest and Abdominal X- Ray. Symptomatic cholecystitis will sometimes show stones on abdominal X- rays if the stones contain calcium. An X- ray of the chest may show pleurisy or pneumonia. However, your doctor should keep investigating even if your X- ray is normal. Ultrasonography. Ultrasonography uses sound waves to produce images of your organs. Ultrasonography is the main method of diagnosis for gallbladder disease and usually reveals the presence of gallstones, thickened walls, or any other problems in your gallbladder. Other Investigations. Blood tests are done to check for increased white blood cells and liver function. Medical Treatment. The first episode of gallbladder inflammation without gallstones is often treated with antibiotics and pain medications. If you have multiple episodes, your doctor may recommend surgery. Surgery. Sometimes surgery to remove the gallbladder is your best option. It can be done either by opening your abdomen, or laproscopically, which involves making three holes and inserting a camera. Laparoscopic surgery allows for easier and faster recovery with minimal scarring. Most surgeons prefer to use this method for those who don’t have urgent complications. The gallbladder may form an abnormal passageway, or fistula, to help process the liver’s bile. ![]() ![]() ![]() This is the most severe problem associated with gallbladder disease. Complications can also include: obstruction of the intestineinflammation perforation (a hole in the gallbladder) bacterial contaminationmalignant transformation. Your diet may play a role in developing gallstones. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), you should eat foods high in fiber and healthy fats to help prevent gallstones. Refined grains (found in sugary cereals and white rice, bread, and pasta) and sugar are associated with a higher risk of gallbladder disease. Whole grains like brown rice and whole wheat bread and fats from fish and olive oil are all recommended. Gallbladder Disease Diagnosis - Gallbladder Disease. Diagnosis of Gallbladder Disease. Abdominal x- rays are not used to diagnose gallbladder disease. Only about 2. 0 percent of gallstones are dense enough to be seen on x- ray—most blend in with the soft tissue structures of the abdomen. Before the advent of ultrasound, the imaging test most used to visualize the gallbladder was the oral cholecystogram. In this test, an oral contrast agent (dye) was given to the patient the night before the test and would be flushed from the body through the gallbladder and bile ducts. When the agent appeared in the gallbladder, the radiologist used fluoroscopic equipment to look for stones. If the dye concentrated in the gallbladder, it indicated that the organ was functioning to some extent. Conversely, if the dye didn't appear in the gallbladder, the gallbladder was not functioning properly and perhaps should be removed. The oral test was able to detect problems in the gallbladder, but was not able to detect problems in other parts of the bile system, such as the main bile duct. To detect other problems, intravenous cholangiogram (IVC) was used. IVC involved special x- rays called tomograms that provided good images of the main bile ducts, enabling the radiologist to detect gallstones. In some cases, however, the images were inadequate due to technical problems, poor uptake of the dye by the liver, and other issues. Ultrasound. In most cases, ultrasound is the first imaging test for gallbladder and bile duct abnormalities. This test is non- invasive, uses no dyes, and is not painful. Ultrasound produces good images of the small ducts in the liver and the higher part of the major bile duct. However, the lower part of the duct, where it enters the GI tract, is where gallstones often get stuck. This lower part is close to the gastrointestinal (GI) tract and air produced in the GI tract deflects the sound waves. If ultrasound cannot detect the condition, other tests that can add valuable information. Radionuclide Biliary Scan. This nuclear medicine test is not only an imaging test, but a function test as well. The patient is given an injection of a radioactive tracer and then imaging is done under a camera for up to several hours, but usually for no more than 3. From this test, the radiologist can determine if the isotope is picked up and excreted by the liver and can often tell if the cystic duct is blocked because, if it is, the gallbladder does not receive any radioactive material. Ordinarily, the tracer should pass right through this duct and end up in the GI tract within a short period of time. If it gets stuck and is not seen in the GI tract, it can be assumed that the main duct is blocked. CT Scan. In most cases, CT scan is not used to detect gallstones, but this imaging test does have its uses in the biliary system. First of all, the entire main duct can be seen using CT scan because unlike ultrasound, air in the GI tract does not interfere with CT. High- speed CT with computer- assisted reformatting capabilities allows the radiologist to move quickly through numerous images. In general, CT scan is a better test for more complicated problems, although it may be used together with ultrasound. The improvements in ultrasound and CT imaging, as well as the emergence of MRI, were important factors in reducing the number of routine transhepatic cholangiograms. Endoscopic Retrograde Cholangiopancreaticogram (ERCP). Endoscopic retrograde cholangiopancreaticogram (ERCP) is often performed by gastroenterologists or surgeons, and not by radiologists. This test involves putting a tube into the patient's mouth, down the throat, into the stomach, through the duodenum and then, into the common bile duct. A smaller tube or catheter is passed through this hole and contrast material is injected. If more complicated issues concerning the gallbladder or bile ducts are suspected, a CT scan, an MRI scan, or both may be performed. Interventional tests, such as ERCP or THC are performed for complicated and serious conditions. Publication Review By: Stanley J. Swierzewski, III, M. D. Published: 0. 1 May 2. Last Modified: 2.
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