Gallbladder enlargement

Introduction Gallbladder enlargement is gallbladder enlargement, gallbladder size is generally <8*3.5cm, gallbladder short diameter>3.5, long diameter>8.0cm can consider gallbladder enlargement, but short diameter longer diameter is more significant, simple long diameter> 8.0cm should not be diagnosed as gallbladder enlargement. This is also the general rule for determining whether all organs are swollen or not. Gallbladder enlargement is common in acute cholecystitis, cholelithiasis and gallbladder cancer. When the gallbladder is palpated, it can touch the enlarged gallbladder, and it has a sexy or physical sensation, and obvious tenderness.

Cause

Gallbladder enlargement is common in acute cholecystitis, cholelithiasis and gallbladder cancer.

1, gallbladder polyps

Commonly known as gallbladder polyps, also known as gallbladder bulging lesions, is a benign space-occupying lesion in the gallbladder cavity. It is more common in cholesterol polyps, more asymptomatic, and some patients have only mild upper abdominal discomfort or pain. It is generally believed that gallbladder polyps are the predisposing factors for gallbladder cancer.

2, cholecystitis

Cholecystitis is a cholecystitis caused by bacterial infection or chemical stimulation (change of bile composition) and is a common disease of the gallbladder. In abdominal surgery, the incidence rate is second only to appendicitis. This disease is more common in middle-aged people aged 35-55 years. The incidence of females is more than that of males, especially in obese women with multiple pregnancies.

3, biliary tumor

Most cancers originate in the head of the pancreas, and the common bile duct passes through it, followed by the bile duct itself, the gallbladder or the intrahepatic bile duct, which is located at the junction of the common bile duct and pancreatic duct. Quite a rare case, the tumor that is transferred from other parts of the body causes obstruction, or is caused by lymph node swelling caused by lymphosarcoma, and benign tumors of the bile duct can also cause obstruction.

an examination

Related inspection

Gallbladder palpation oral cholecystography

In clinical practice, patients with gallbladder enlargement must first see whether there is a history of infection, clinical symptoms and signs, and identify gallbladder enlargement caused by diseases such as cholecystitis, gallbladder polyps, gallstones, etc.; second, physical examination, gallbladder At the time of palpation, the enlarged gallbladder can be touched, and there is a sexy or physical sensation of the capsule, and obvious tenderness. Third, a laboratory examination should be performed, and if necessary, an examination of the liver and gallbladder should be performed to determine the cause and severity of gallbladder enlargement. One step of treatment provides the basis.

Differential diagnosis

Differential diagnosis of gallbladder enlargement:

First, the gallbladder wall is thin: papillary adenocarcinoma may be caused by malignant papillary or polyps, the tumor grows into the gallbladder cavity, affecting the emptying of the gallbladder, the surface of the tumor is ulcerated, easily causing infection. If the tumor blocks the gallbladder neck, it can enlarge the gallbladder and thin the gallbladder wall, similar to gallbladder abscess or effusion.

2. Gallbladder hydrops: The blood vessels that supply gallbladder nutrition are terminal arteries. When the outlet of the gallbladder is blocked, the gallbladder mucosa continues to secrete mucus, causing the pressure in the gallbladder to increase, causing the gallbladder to swell and accumulate water. Compression and ischemia, necrosis. When the gallbladder is ischemia, the gallbladder resistance is reduced, the bacteria are easy to grow and multiply, and the cholecystitis occurs when the machine is activated. Cholecystitis is a cholecystitis caused by bacterial infection or chemical stimulation (change of bile composition) and is a common disease of the gallbladder. In abdominal surgery, the incidence rate is second only to appendicitis. This disease is more common in middle-aged people aged 35-55 years. The incidence of females is more than that of males, especially in obese women with multiple pregnancies.

Third, 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.

Fourth, gallbladder volume reduction: clinical adjuvant examination of cystic duct syndrome After the injection of CCK intravenously, the gallbladder volume shrinks no more than 45%. Biliar Cystic Duct Syndrome refers to a mechanical non-calculus partial obstruction of the cystic duct, which causes a poor discharge of bile and a group of clinical syndromes characterized by biliary colic as a result of elevated gallbladder pressure. Intrinsic is also known as cystic duct partial obstruction syndrome, gallbladder dyskinesia syndrome, primary chronic cysticulitis, Cozzolino cystic duct syndrome.

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