Gallbladder wall fibrosis

Introduction Fibrosis of the gallbladder wall is mainly caused by inflammation of the gallbladder wall and fibrosis, and the gallbladder is in a contracted state, so-called chronic acalculous cholecystitis. There may be symptoms of indigestion in the right upper abdomen, such as pain, acid reflux, belching, and abdominal distension. It is obvious after ingesting greasy food. If accompanied by infection, there may be symptoms of acute cholecystitis. Stones in the cystic duct may have biliary colic, sudden onset of persistent upper right abdomen, paroxysmal aggravation, release to the shoulder and back, accompanied by nausea and vomiting.

Cause

Due to stones in the gallbladder or the neck of the gallbladder, infection and obstruction are caused. Such a condition may be related to the problem of cystic duct syndrome, gallstone inflammation stones, colonic hepatic syndrome, and the syndrome of cholecystectomy, ascariasis of gallbladder, acute cholecystitis, Caused by diseases such as calculous cholecystitis and carcinoid.

an examination

Related inspection

Intravenous cholangiography CT examination of liver, gallbladder and spleen

First, the medical history question

1, gallstones in the gallbladder generally do not produce symptoms of biliary colic, called resting stones, may have right upper quadrant pain, acid reflux, belching, abdominal distension and other symptoms of dyspepsia, after eating greasy food, if accompanied by infection May have symptoms of acute cholecystitis.

2, gallbladder tube stones may have biliary colic performance, sudden right upper quadrant persistent pain, paroxysmal aggravation, release to the shoulders and back, accompanied by nausea, vomiting.

Second, physical examination found

1. There is no positive sign in the gallstones of the gallbladder. When a few stones are too large, the gallbladder can be touched.

2, gallbladder tube stones, right upper abdomen tenderness, Murphy sign positive, right upper abdomen can touch the enlarged gallbladder, there is tenderness, such as the occurrence of gallbladder perforation can have signs of acute peritonitis such as total abdominal tenderness, rebound tenderness, muscle tension. Some patients may have jaundice.

Third, laboratory inspection

If there is perforation of the gallbladder, the flat film of the abdomen can be seen as free gas.

Differential diagnosis

Differential diagnosis of gallbladder wall fibrosis:

1, gallbladder dyskinesia: common in cystic duct syndrome, refers to incomplete cystic duct, non-calculus, mechanical obstruction, causing poor bile discharge, elevated gallbladder pressure caused by a group of biliary colic It is the main symptom of clinical syndrome. Intrinsic is also called cystic duct partial obstruction syndrome, gallbladder dyskinesia syndrome, primary chronic cysticulitis. According to typical pain, gallbladder angiography without stones and gallbladder filling, fat bile can not be fully empty after the meal, cystic duct syndrome should be suspected, but other auxiliary examinations are needed for the diagnosis.

2, gallbladder wall thinning: papillary adenocarcinoma may be caused by malignant papillary or polyps, tumors grow into the gallbladder cavity, affecting gallbladder emptying, tumor surface ulcers, easy to cause infection. If the tumor blocks the gallbladder neck, it can enlarge the gallbladder and thin the gallbladder wall, similar to gallbladder abscess or effusion.

3, gallbladder enlargement: patients with acute cholecystitis with gallbladder ultrasound examination often found gallbladder enlargement, thickening of the gallbladder wall, gallstones within the gallbladder. Acute cholecystitis is inflammation of the gallbladder caused by cystic duct obstruction and bacterial invasion. Its typical clinical features are paroxysmal cramps in the upper right abdomen, accompanied by obvious tenderness and abdominal muscle rigidity. About 95% of patients have gallstones, called calculous cholecystitis, and 5% of patients have no gallstones, called acalculous cholecystitis.

4, gallbladder systolic dysfunction: diagnosis of biliary tract hypotension syndrome can be found after fat meal gallbladder contraction dysfunction. The biliary hypotony syndrome, also known as Chiray syndrome, refers to a group of syndromes in which biliary tract tension is delayed, gallbladder emptying is delayed, and indigestion occurs, which can not tolerate fatty foods and has pain in the right upper quadrant. Intrinsic to the category of biliary dysfunction syndrome, also known as gallbladder retardation syndrome.

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