what is Gall Bladder? function embryonic development and diseases related to gall bladder

GALL BLADDER

Introduction
Digestive system is a very complex system and it consist of various structure and for its proper working it also requires various material such as secretions and one of the most important secretion that is required by the digestive in order to work is bile and this bile is produced in liver and than after its formation it is stored temporally and concentrated in a special organ that goes by the name of gall bladder the site of action of this bile is human small intestine and this bile that is produced in the gall bladder goes to the small intestine through bile duct and small intestine receives this bile at the level of sphincter of oddi that is located few inches below the stomach and this bile goes into the duodenum section of the small intestine. Gall bladder is also connected with the liver through a duct that goes by the name of biliary tract. Gall bladder is a component of digestive system and the precursor from which the gall bladder develops is the foregut. Gall bladder in humans is a small pouch like structure that is present just below the right lobe of liver in a depression as it also receives its bile from liver. We can define gall bladder that it is small pouch like muscular structures that receives bile from liver after which bile is temporarily stored in it than it is send to duodenum section of the small intestine. Gall bladder is very important but a person can live without it such as in people whose gall bladder is removed due to any medical condition. Most of the vertebrates have gall bladder but the form and arrangement of gall bladder differs in different spices. As a whole the structure of all bladder are divided into following section

  • neck 
  • fundus 
  • body
In adult human the dimensions of gall bladder are such that

  • in length it is about 7 - 10 cm
  • its diameter is about 4 cm
  • it has a capacity of 50 - 60 ml  
in gall bladder there is a structure or pouch to be more precise present that is known as the Hartmann's pouch that was named after a french surgeon Henri Alert Hartmann and it is actually an out pouching of the gall bladder wall. The muscular fibers of the gall bladder contracts and pushes the bile of out it and send it to the duodenum of the small intestine. Sometimes variations can occur in the position or size of the gall bladder and one such anatomical variation of the gall bladder is know by the name of phrygian cap in which there is and additional harmless fold present in the fundus section of the gall bladder. For any organ of the body to work properly and effectively there are some requirement or we can say that some basic needs such as blood supply of that organ nervous supply as well as lymphatic supply or lymphatic drainage. Such as if we consider that blood supply of the gall bladder that the oxygenated blood to the gall bladder is provided by the 
  • cystic artery 
after supply of deoxygenated blood there will be of course deoxygenated blood and the vein that is responsible for removing of deoxygenated blood from the gall bladder is as following 
  • cystic vein 
on the other hand nervous supply for any organ to function is also very essential and the nervous supply to the gall bladder is provided by the following nerves 
  • vagus nerve 
  • celiac ganglia
so one other important thing for any organ is its lymphatic drainage and in case of gall bladder all of the lymphatic drainage goes into the cystic node which than drains into lower hepatic lymph nodes which than eventually drains into the celiac lymph.     





Embryonic Development of Gall Bladder
The precursor of gall bladder from which it develop during the time of embryonic development is the foregut and this gall bladder is a part of digestive system as it receives bile from the liver and than after storing and concentrating for sometime it sends this bile to the duodenum section of the small intestine. During the second week of the embryonic development there is starting of formation of the gastrointestinal tract and during which the foregut starts to differentiate into various organs of the gastrointestinal tract and it is the time during which the formation of gall bladder from the foregut starts to take place. During the 4th week of the embryonic development the formation of various sections of small intestine such as duodenum starts to from and by the end of this 4th week of the embryonic development gall bladder also starts to form in such a way that duodenum spouts as a small out pouching and on the right side side of which hepatic diverticulun forms the biliary tree. The first out pouching that we had was of duodenum and we have another out pouching that is called by the name of cystic diverticulum that is just below the biliary tree and this cystic diverticulum will eventually form the gall bladder. By the fifth week of the embryonic development all the elements of the biliary tree are recognizable. Early in the seventh week of the embryonic development the bile and the pancreatic ducts ends in cavities of the duodenum. Th development of sphincter of oddi is between the eight and twelfth week of the embryonic development    


Function of Gall Bladder
As gall bladder is a part of digestive system there fore it is involves in the of digestion as it gets bile from the liver and after storing it and concentrating it for some time it sends this bile to the duodenum section of the small intestine where this bile performs its function and aids in the digestion. The normal the bile stores in the gall bladder its gets more concentrated as water and electrolytes gets removed from it and the concentration of bile that gall bladder receives is not equal to the concentration of the bile that is gives to the duodenum of the small intestine. The process of transferring of bile from gall bladder to duodenum is such that when the food enters in to the digestive system there is a production of a stimulant from the inclusion cells and this stimulant is known as the cholecystokinin and as result of this cholecystokinin the muscular layer of the gall bladder contracts and it transfers the bile into common bile duct that pours this bile into the duodenum of the small intestine through the sphincter of odd. Gall bladder has a capacity of 50 - 60 ml such that at once about 50 - 60 ml of bile can be stored in the gall bladder. Bile flows out of the liver through the left and the right hepatic ducts which come together to the common hepatic duct this duct joins with the gall bladder and it is this duct through which bile from the liver flows into the gall bladder. Than after liver gall bladder bile is carried to the duodenum by the help of the common bile duct and it eventually pours the bile into the duodenum section of the small intestine through an opening that is known as the sphincter of oddi. This bile is involved in the process of of digestion and it includes various things such as 
  • water 
  • electrolytes 
  • sodium 
  • bicarbonates 
  • cholesterol
  • bile pigments
  • bilirubin 
  • bile salts 
there is also absorption of various substances from the bile at various levels of intestine. Such that when bile enters in the the small intestine and performs its function about 90% of the bile salts are reabsorbed into the blood steam through the lower wall of the lower small intestine. Some bile salts are reabsorbed in the large intestine where as some of the bile salts are excreted through the stool. This cycle of re-absorption of bile salts occurs few times a day. The bile salts that goes into the blood stream extracted by the liver through the blood steams and liver uses them again.


Diseases of Gall Bladder
Like any other organ of the body if there will be any disturbance in its basic needs than it will show abnormality. Similarly gall bladder will also show abnormalities if there will be any problem in its structure development secretion supply or there can be numerous other reasons as a result of which gall bladder can show abnormality which can also be converted into some sort of disease. If a person is suffering from gall bladder disorder than along with the medications he can also improve his diet by leaving somethings and taking such as a person suffering from gall bladder disease should avoid 
  • process foods as they are rich source of sodium and other preservatives 
  • fine and simple carbohydrates  
  • unhealthy fats or cholesterol
instead of these things such a person should take take followings in his diet
  • healthy fats such as from fish nuts 
  • complex carbohydrates
  • fresh fruits and vegetables 
  • majorly plant based proteins 
  • calcium 
  • certain vitamins such as vitamin C 
there are some common symptoms that are shown in the body as a result of any gall bladder disorder than these general symptoms are as following
  • fever with chills 
  • diarrhea
  • problem in urine and stool 
  • jaundice 
  • vomiting 
  • nausea
  • mild pain in upper right section of abdomen 
  • pain after eating 
  • bloating 
  • excessive fullness after eating 
  • pain after eating 
these were some general symptoms of the disorders that may be related to gall bladder disorder one thing is to cleared at this point and it is that these are general symptoms and may be shown in shown in some other disorder so we have some specific test for the detection of gall bladder related problems and they are as following

  • abdominal ultrasound
  • endoscopic retrograde cholangiopancreatography  
  • complete blood count
  • cholescintigraphy
  • magnetic resonance cholangiopancreatography
  • abdominal x rays 
  • computed tomography
  • liver function test
where as some of the methods that are used for the treatment of diseases of gall bladder are following 
  • cholecystectomy
  • ursodeoxycholic acid 
  • antibiotics
  • contact solvent dissolution
  • chemotherapy
  • radiation therapy
  • extra-corporeal shock wave lithotripsy 
these were common symptoms methods of treatments or the way to find out if there is any sort of problem in the gall bladder but the main thing along with which these are associated are the gall bladder disorders and some of the disorders of gall bladder are as following
  • cholecystitis 
  • cholelithiasis   
  • gallstone pancreatitis 
  • gall bladder cancer 
  • choledocholithiasis 
  • common bile duct infection 
  • abscess of gall bladder 
  • gall stone ileus 
  • porcelain gall bladder
  • gall bladder polyps 
  • perforated gallbladder
Cholecystitis
Cholecystitis is one of the condition or disorder of the gall bladder in which there is an inflammation of the gall bladder. As gall bladder is responsible for storing bile if there would be any blockage in the ducts that carry bile out of the gall bladder than the bile would be accumulated in the gall bladder and can cause an inflammation other causes of inflammation of the gall bladder may be some kind of infection tumor formation of it may be problems related to its ducts. This condition can be acute as well as chronic. Some of the common symptoms of the cholecystitis are as following 
  • vomiting
  • nausea
  • pain in the area of abdomen where gall bladder is situated 
  • fever
  • chills 
  • abdominal bloating 
  • abdominal cramping 
  • stool problems 
  • itching 
some of the common methods or test that are used to diagnose cholecystitis are as following 
  • abdominal ultrasound 
  • abdominal computed tomography 
  • hepatobiliary nuclear imaging 
  • magnetic resonance cholangiopancreatography
  • blood test to identify any infection

Cholelithiasis 
Cholelithiasis is a condition of gall bladder in which there is formation of stones or in short you can say gall stones. As the nature of the stones formed in the gall bladder are concerned than they may be of cholesterol stones or pigment stones and usually they do not cause pain unless they do any sort of blockage. Some of the common causes of cholelithiasis are as following 
  • high cholesterol level
  • increased concentration of bilirubin in bile 
  • gall bladder not having proper contractions as a result of which all of the bile do not gets out of it   
some of the common symptoms of cholelithiasis are as following 
  • pain in right section of abdomen 
  • back pain 
  • nausea
  • vomiting 
  • high fever 
  • chills 
  • yellowing of skin 
the test or techniques that are used to detect cholelithiasis are as following 
  • abdominal ultrasound
  • magnetic resonance cholangiopancreatography
  • endoscopic retrograde cholangiopancreatography 
  • blood test
the gall stones are usually removed through surgery or through different medications

 Gallstone Pancreatitis
Gall stones pancreatitis is a condition in which gall stones blocks the pancreatic duct causing inflammation and pain in the pancreas. Gall stones are usually formed in the gall bladder but in some conditions these stones may travel to the duodenum and blocks its opening as a result of which there will be a bile accumulation that will travel both to the bile duct as well as to the pancreatic duct and if not treated this can be a very harmful situation for the person. Some of the common symptoms of the gall stone pancreatitis are as following 
  • fever 
  • chills 
  • vomiting 
  • jaundice
  • pain in upper left abdomen 
  • vomiting 
to diagnose gall stones pancreatitis following test or techniques are used 
  • blood test 
  • computed tomography scan 
  • MRI
    

Comments

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