The document discusses conditions affecting the gallbladder. It describes the gallbladder's function of storing and releasing bile to aid digestion. Gallstones are formed when there is too much cholesterol or bilirubin in the bile and can cause blockages. Symptoms of gallstones include pain in the upper abdomen or back. Treatment options include medications to dissolve small stones, surgery to remove the gallbladder (cholecystectomy), or opening blocked ducts endoscopically. Complications arise if gallstones block important ducts, and may require hospitalization.

1. CONDITIONS AFFECTING THE
GALL BLADDER
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3. REVIEW OF SYSTEMS
• Gallbladder: A pear-shaped organ located below the liver that stores
the bile secreted by the liver.
• During and after a fatty meal, the gallbladder contracts, delivering the
bile through the bile ducts into the intestines to help with digestion.
• Produced in the liver, bile is a combination of cholesterol, bilirubin, bile
salts and lecithin. This solution helps break down fat during the digestion
process.
• Bile is either released directly to the small intestine from the hepatic duct
(coming straight from the liver) or from the bile ducts after being stored in
the gallbladder. The entire system of ducts is called the biliary
system/the biliary tree.

4. Signs and symptoms of gallbladder
disorders.
• Chest pain.
• Chills.
• Clay-colored stool.
• Feeling of fullness.
• Heartburn, indigestion, and excessive gas.

5. CHOLELITHIASIS

6. • Cholelithiasis is also known as gall stones disease.
• Gallstones are stone-like objects that develop in the gallbladder or
bile ducts (the pipe-like system within the liver).
• Gallstones range in size, from tiny grains of sand to golf ball-sized
objects.
• smaller stones can often cause the most trouble. These are stones
that can leave the gallbladder and get stuck.
• Larger stones tend to remain quietly in the gallbladder.

7. CONT..
• There are two types of gallstones:
• Cholesterol gallstones: These are the most common form
and are primarily made up of undissolved cholesterol.
• Pigment gallstones: Made up of excess bilirubin (a pigment
that forms during the breakdown of red blood cells), these
stones are brown or black.

8. WHY DO GALLSTONES DEVELOP?
• Gallstones can develop for several reasons, including:
• Forming when there is a critical concentration of cholesterol or
bilirubin in the bile.
• Developing if the gallbladder is lazy and does not completely empty
itself of bile.
• Occurring in people with other conditions, like:
• Cirrhosis of the liver.
• Blood disorders.
• During pregnancy.
• When a person rapidly lose weight.

9. Illustration of how the gall stones block the
biliary tract

10. HOW GALL STONES ARE FORMED
• Gallstones occur when bile forms solid particles (stones) in the
gallbladder.
• The stones form when the amount of cholesterol or bilirubin in the
bile is high.
• Poor muscle tone may keep the gallbladder from emptying
completely. The presence of residual bile may promote the
formation of gallstones.
• After formation, small stones are able to leave the gall bladder
and block the common duct. Leading to back flow of bile into the
gall bladder or the liver
• Bigger stones are static in the gall bladder, pain is felt when the
bladder contracts to release the bile.

11. SIGNS AND SYMPTOMS
• Pain in the Upper part of the abdomen, on the right side /Between
the shoulder blades /Under the right shoulder.
• Nausea and vomiting.
• Jaundice (a yellow tint to the skin and eyes).
• indigestion, belching, bloating,
• intolerance for fatty or greasy foods,

12. INVESTIGATIONS
• Biliary tree Endoscopy
• cholecystogram with Xray- patient is made to take a
dye that stains the biliary tree which will reveal if
there are any obstructions
• MRI/CT Scan will show the structures and if theres any
blockage

13. TREATMENT
HOME REMEDIES
• Apple juice
• Apple cider vinegar
• Lemon tea
• Vegetable tea
Others
• avoid fatty or greasy meals
• Take a lot of water and avoid carbonated drinks

14. DRUGS
Ursodeoxycholic Acid
• Ursodeoxycholic acid (ursodiol, Actigall) dissolves up to 80
percent of very small gallstones within six months.

15. •SURGERY
➢Cholecystectomy- removal of the gall bladder.this is done
when the stones are too big and have destroyed the
structure of the bladder. This can be done by two ways:
• Laparascopic cholecystectomy
• Open cholecystectomy
• NB: patient does not suffer due to removal as bile jst
moves from the liver into the duodenum

16. Complications
Complications of gallstones may include:
• Inflammation of the gallbladder. A gallstone that becomes lodged in the neck of
the gallbladder can cause inflammation of the gallbladder (cholecystitis).
Cholecystitis can cause severe pain and fever.
• Blockage of the common bile duct. Gallstones can block the tubes (ducts)
through which bile flows from your gallbladder or liver to your small intestine.
Severe pain, jaundice and bile duct infection can result.
• Blockage of the pancreatic duct. The pancreatic duct is a tube that runs from
the pancreas and connects to the common bile duct just before entering the
duodenum. Pancreatic juices, which aid in digestion, flow through the pancreatic
duct.
• A gallstone can cause a blockage in the pancreatic duct, which can lead to
inflammation of the pancreas (pancreatitis). Pancreatitis causes intense, constant
abdominal pain and usually requires hospitalization.
• Gallbladder cancer. People with a history of gallstones have an increased risk of
gallbladder cancer. But gallbladder cancer is very rare, so even though the risk of
cancer is elevated, the likelihood of gallbladder cancer is still very small.

17. BLOCKAGE OF THE BILLIARY
TRACT

18. • DEF: Biliary obstruction is a blockage of the bile ducts.
• The bile ducts carry bile from the liver and gallbladder through
the pancreas to the duodenum, which is a part of the small
intestine.
Types of bile ducts
• Intrahepatic ducts. Intrahepatic ducts are a system of
smaller tubes within the liver that collect and transport bile to
the extrahepatic ducts.
• Extrahepatic ducts. The extrahepatic ducts begin as two
parts, one on the right of the liver and the other on the left. As
they descend from the liver, they unite to form the common
hepatic duct. This runs directly toward the small intestine.

19. causes of biliary obstruction
• Gallstones
• inflammation of the bile ducts(Cholangitis )
• trauma
• a biliary stricture, which is an abnormal narrowing of the duct
• an injury related to gallbladder or liver surgery
• tumors that have reached the liver, gallbladder, pancreas, or
bile ducts
• cirrhosis, or scarring of the liver
• severe liver damage
• Birth defects

20. Signs and symptoms
• light-colored stools
• dark urine
• jaundice (yellowish eyes or skin)
• pain in the upper right side of the abdomen
• nausea
• vomiting
• weight loss
• Itching on the skin

21. INVESTIGATIONS
• Ultra-sound scan
• Liver function tests
• MRI/CT scan
• Cholangiogram with XRAY

22. TREATMENT
• Cholecystectomy if the cause is due to gall stones
• endoscopic retrograde cholangiopancreatography this visualizes
the biliary tree and can take biopsy as well as used to cut or enlarge
the tract.