Gallbladder Diseases PDF

Gall bladder diseases The gallbladder is a small muscular bag located under the liver in the upper right region of the abdomen with one opening from the top that connects it to a short tube branching from a long duct that comes from the liver to the first part of the small intestine, or the so-call...

Gall bladder diseases The gallbladder is a small muscular bag located under the liver in the upper right region of the abdomen with one opening from the top that connects it to a short tube branching from a long duct that comes from the liver to the first part of the small intestine, or the so-called duodenum. Gallbladder connects three organs of your body: the liver, gallbladder, and small intestine Liver cells continuously secrete a viscous liquid with a greenish- golden color and a bitter taste called bile to play an important role in the digestion and absorption of fatty substances and cholesterol, as well as the absorption of fat-soluble vitamins. The gallbladder (1) collects and (2) stores bile and (3)increases its concentration (the liver secretes 600-800 ml of bile, the gallbladder concentrates it to 40-70 ml/day). Bile: acids + bile pigments + water + cholesterol + lecithin+ Bilirubin (breakdown of RBC) When a person eats and food reaches the intestine, the lining of the intestine tells the gallbladder that it needs the juice that it has preserved. This is done through an immediate chemical message represented by the hormone cholecystokinin, which is secreted by the lining of the intestine and is transmitted through the blood to the gallbladder. 1- Acute inflammation of Gallbladder (Cholecystitis)  Reasons 1- The presence of stones that block the duct connecting the gallbladder to the general bile tube and lead to scratching the wall. 2- Transfer of germs (Salmonella germ) from the duodenum to the gallbladder Factors causing acute cholecystitis ❑ Diabetes ❑ Pregnancy ❑ Weight gain and rapid weight loss ❑ Person undergoing surgery ❑ Heart disease ❑ AIDS  Symptoms 1- Severe sharp pain in the right region of the upper abdomen that may reach the right shoulder joint. (The pain may last more than 6 h.) 2- A slight rise in temperature 3- Nausea, vomiting and indigestion 4- Yolk of eyes and skin may be present in 15% of patients. 5- When the doctor puts his hand in the right region of the upper abdomen and then asks the patient to take a deep inhale, the patient cannot complete this inhale because of the pain, and this matter must also not be present in the left region above the abdomen. These symptoms may be caused by other diseases, not the gallbladder, such as: ❑ Peptic ulcer ❑ Acute Hepatitis ❑ pancreatitis ❑ Right kidney stone ❑ acute renal colic ‫مغص‬  2- Chronic Cholecystitis  Two type of cholecystitis 1- Such as acute inflammation (where 2- The patient is often the patient complains of pain in the obese and feels digestive right side of the abdomen to the point disturbances + where it is difficult to touch + high always feels full and temperature), and here the patient bloated + complains in a continuous and the presence of acidity in permanent. We found that the patient with chronic the stomach after eating cholecystitis complains of a number of fatty foods. symptoms when he eats a fatty meal It is often accompanied by such as butter and fats stones  Treatment 1- Eat easy-to-digest meals + reduce fat to 15% of total calories to prevent gallbladder contraction 2- Avoid sulfur foods (cabbage, cauliflower, radish, onions, green peppers), spices, pickles, beans, legumes, eggplant, watermelon , cantaloupe and fried foods ‫ال نلجأ الي تجنب الدهون نهائيا حتي تستمر المرارة في اداء وظائفها ولكن بدون التسبب في االلم‬ 3- Gall stones (Cholelithiasis )  Gallstones : are the presence of solid bodies in the bile, and it is a very common disease in both sexes, but it is more common in women ( estrogen hormone raise the level of cholesterol) than in men (1:3). It is more common with age. Reasons: ❑ Genetic predisposition ❑ Obesity (morbidity), Rapid weight reduction ❑ Increased cholesterol , high fatty diet ❑ Contraceptive drugs ❑ Lack of bile emptying and increase in its density due to lack of drinking fluids or increased retention in the gallbladder (due to some diseases: diabetes, oral contraceptive, fasting for long periods ) ❑ Infection of the ducts that transport bile from the liver to the intestines with some bacteria, such as Escherichia coli, or with some parasites.  Stones (cholesterol) Cholesterol is deposited in the bile due to (insufficient lecithin), which maintains cholesterol in liquid form. Stones (bile salts) When the bile salts are increased too much, it leads to its precipitation- It's black  Symptoms 1- The same symptoms of cholecystitis 2- In the event of a lack of bile secretion, the patient will develop yellowing in color and Steatorrhea ‫ عن طريق‬Fat soluble vitamins ‫في حالة االسهال الدهني يجب التاكد من اعطاء‬ ‫االدوية‬  Treatment 1- If there is surgery (determine the fat before the operation to prevent constriction of the bile duct, it is preferable to give 20 g of fat and then increase to 50 g / day when improvement). 2- If the patient has obesity (the operation is postponed until the weight is lost) 4- Small and frequent meals 5- Avoid foods (roasted - filling - full fat - eggs (one per day). ‫في حالة استئصال المرارة يبدأ التغذية عن طريق الفم بمجرد سماع صوت االمعاء والتاكد من حركتها‬