Gallbladder dysfunction

Introduction Diagnosis of biliary tract hypotension syndrome can be found to be dysfunction of gallbladder contraction after fat meal. 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. Pathologically, there is gallbladder dilatation and disappearance of the gallbladder neck, which is mainly due to autonomic dysfunction, vagal dysfunction, and decreased secretion of cholecystokinin.

Cause

Pathologically, there is gallbladder dilatation and disappearance of the gallbladder neck, which is mainly due to autonomic dysfunction, vagal dysfunction, and decreased secretion of cholecystokinin.

an examination

Related inspection

Ultrasound examination of gallbladder biliary tract B-ultrasound

Oral gallbladder angiography or B-mode ultrasound can be found in gallbladder enlargement, and gallbladder systolic dysfunction after fat meal. In the case of biliary organic diseases except cholelithiasis, biliary ascariasis, biliary infection, etc., the intrinsic can be considered.

Differential diagnosis

Differential diagnosis of gallbladder systolic dysfunction:

First, gallbladder wall fibrosis: When inflammation occurs in the gallbladder wall and fibrosis occurs, the gallbladder is in a contracted state, so-called chronic acalculous cholecystitis.

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.

Second, lazy sac: one of the main types of inactive gallbladder, biliary dysfunction, accounting for about 8%. This type is characterized by an increase in the volume of the gallbladder in the fasting state, and the appearance resembles a "U" shape, and the contraction and emptying of the gallbladder after the fat meal are slowed down. However, in patients with chronic acalculous cholecystitis, if there is a thinning of the gallbladder wall and severe damage to the mucosa, the gallbladder is not even seen at all.

Third, biliary dysfunction: including biliary dysfunction (dyskinesis, that is, abnormal biliary emptying speed), biliary tract abnormalities (dystonia, that is, abnormal biliary muscle tone) and biliary ataxia (ataxic, that is, coordination between various parts of the biliary tract ). The disease is more common in women, its clinical manifestations and gallstones are very similar, mainly for abdominal pain, paroxysmal cramps in the upper abdomen or right upper abdomen, some patients may be accompanied by nausea and vomiting, may be induced by eating greasy food, often lasting 2 ~3h, the symptoms are relieved after the antispasmodic drug.

Fourth, bile stasis: imaging diagnosis, most of the gallbladder stones in the early stage can be expressed as bile stasis and then formed bile mud, stones. The white blood cell count was significantly increased, the urinary tricholic abnormalities, elevated blood bilirubin, and abnormal liver function (such as ALT, AST, r-GT, ALP, etc.) increased to varying degrees. B-ultrasound, CT examination showed gallbladder enlargement, bile duct expansion and calculus, ERCP, PTC examination can more clearly show the lesions inside and outside the bile duct.

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