Deformation of the gallbladder

Actually, the deformation of the gallbladder is not considered any disease: it is only a sign, a congenital or acquired feature of the organ.

Of course, patients with this diagnosis need to carefully monitor the rest of the diet, digestive and physical loads, etc. More information about this condition of the gallbladder can be found in our article.

ICD Code 10

The ICD of the tenth revision is a single list for the classification of diseases and the statistics of patient requests for medical care. The next revision of this register is planned for 2015.

Deformation of the gallbladder can be noted in the ICD 10 in the following categories:

• Q44 - congenital defect or vice of bile excretory organs;
• Q44.1 - Other congenital gallbladder defects;
• K82 - other diseases of the gallbladder;
• K82.0 - narrowing of the gallbladder or ducts, not associated with stone formation;
• K82.9 - Disease of the gallbladder, unspecified.

Causes of Gallbladder Deformation

Causes and factors preceding the deformation of the gallbladder can be quite a lot. Usually such reasons are divided into those that were formed before birth, as well as those that appeared later.

Congenital deformity of the gallbladder can appear as a result of any violations of the fetal formation of the unborn child. The cause may be hereditary predisposition, as well as the way of life of a pregnant woman: abuse of nicotine, alcoholic beverages, excessive physical activity.

As reasons for the acquired deformation of the gallbladder, consider the following:

• chronic inflammatory process of bile ducts;
• stones in the gallbladder or ducts;
• systematic overeating, alternation of strict diets (when relative starvation is replaced by attacks of gluttony), eating disorders;
• excessive physical exertion on the abdominal muscles;
• adhesive process;
• weakening of the diaphragm;
• diseases of the digestive system;
• dyskinesia of bile ducts;
• malignant and benign neoplasms.

Deformation of the gallbladder can be associated with age: in older patients, there may be a drop in some internal organs, including the gall bladder. Especially often this problem arises as a consequence of a hernia of the abdominal wall, and also after some surgical interventions on the organs of the abdominal cavity.

[1], [2]

Symptoms of gallbladder deformity

Symptoms of deformation of the gallbladder depend, first of all, on the speed of the development of the process.

If the deformation appears sharply, then the symptomatology can be expressed in the form of increasing pain in the place of projection of the liver and gallbladder. Simultaneously with the patient's pain, the yellowness of the skin and mucous membranes increases, there are bouts of nausea, disgust for eating. It is possible to increase body temperature. With a deep feeling, the area of the projection of the liver is very painful. When inspecting the tongue, a dense yellow coating is found.

If the deformation develops gradually, the signs of pathology can occur simultaneously with impaired capacity of the bile ducts due to changes in the shape of the organ. With gradually forming deformation, the following symptoms can occur:

• loss of appetite;
• decolorization of fecal matter;
• Detection of fatty elements in fecal matter;
• slow weight loss.

Patients with gradual deformation may indicate an unchanging feeling of heaviness of the right hypochondrium region, burning soreness along the entire length of the small intestine, dyspeptic disorders.

The greatest danger is necrosis of the cervical segment of the gallbladder due to prolonged deformation, which can provoke the decomposition of tissues and the penetration of bile fluid into the abdominal cavity. This, in turn, can cause peritonitis and death if the patient does not provide timely assistance.

Common variants of gallbladder deformity

According to anatomical data, the gallbladder can be virtually divided into three sections: the cervical region, the bottom and the body of the bladder. The most common deformity of the gallbladder is an inflection between the body and the bottom. Such an excess is symptomatically characterized by the appearance of nausea, increased sweating, acute soreness in the hypochondrium on the right, giving off to the scapula and ribs. Possible changes in complexion, weight loss. Failure to provide assistance in this situation can lead to extremely negative consequences, which we will discuss later.

Multiple deformations of the gallbladder by an inflection (a violation of the shape of the organ simultaneously in several places) also occurs, but less frequently. Such a pathology can contribute to an increase in the size of the gallbladder, the formation of calculous cholecystitis, the development of adhesions, the disorder of blood flow in the liver. The patient's condition is usually severe, with clear symptoms of dyspepsia and severe pain.

Often it is possible to meet such a diagnosis as a labile deformation of the gallbladder. Labile deformation is a temporary phenomenon that occurs during heavy physical exertion, when wearing weights, and for other reasons. Such a disorder is usually not accompanied by any symptoms and passes on its own after a while.

No less often one can find another variant of deformation - this is the deformation of the neck of the gallbladder. Usually, this phenomenon appears against the background of a slow chronic inflammation - cholecystitis. In this case, the inflammatory process extends to the outer walls of the gallbladder: spikes are formed, which lead to deformation of the organ. This condition contributes to the disturbance of the digestive process and even changes the composition of the biliary secret. Sometimes, neck deformation is a complete twisting of the gallbladder around its axis. This situation can develop as a result of the omission of some internal organs, which can happen because of prolonged physical overloads, due to lengthening of the cervical section of the gallbladder, or its sagging. Rarely there is a twisting of the organ in the neck area several times: this situation is considered the most critical, as it inevitably leads to a violation of blood flow in the organ.

Deformation of the gallbladder walls can occur against the background of chronic cholecystitis, which is associated with sclerotic changes in the walls of the organ, or with the development of an adhesion in the bottom region. Deformation of the gallbladder walls is perfectly distinguishable during ultrasound diagnosis. An ultrasound specialist will notice protrusions, marginal cavities, sometimes calcium deposits near the walls of the organ, which together affects the overall picture of the gallbladder.

To the types of deformation of the walls is the contour deformation of the gallbladder. The essence of this violation is clear from the name: there is a change in the contours of the organ. Normally, the gallbladder resembles a pear-shaped formation connected to the liver by the lower part. With contour deformation, the outline of the gallbladder changes in one direction or the other. This can be caused by a chronic inflammatory process in the organ, or a violation of the excretion of bile. As a rule, severe contour deformation is accompanied by pain, especially after eating, or as a result of stress or heavy lifting.

Deformation of the body of the gallbladder, according to statistics, can occur in 15% of absolutely healthy people. Often, this defect is detected by chance and may not affect the digestive process and the patient's well-being. However, many people eventually start to notice a violation of the motor function of the gastrointestinal tract, the formation of sediment and stones in the gallbladder, the development of cholecystitis. The probability of complications is due to the nature and degree of deformity, as well as the way of life and nutrition of the patient. In any case, if any of the variants of the gallbladder deformation is found, periodic observation with the doctor is recommended.

And one more kind of deformation that I would like to mention is the S-shaped deformation of the gallbladder. Such a violation is a double kink of the organ in the form of a letter S. Most often this is an innate deformation of the gallbladder, with the possibility of hereditary transmission from the mother or father of the child. Less commonly, the acquired S-shaped deformation occurs, which results from the advance of the growth of the gallbladder relative to other nearby organs. This pathology does not always occur with any symptoms. The course can be hidden and not cause problems to the patient. Only in some cases, symptoms may appear: dull tenderness in the liver, bitterness in the mouth, stool disorders, "empty" eructations. If outflow of bile is disturbed from the altered bladder, then problems with digestion of fatty foods, flatulence, dyspepsia are possible.

Different deformations of the gallbladder are not a verdict. The situation can be alleviated if timely measures are taken to change the diet and lifestyle in order to facilitate the work of the bile-forming and bile-excreting organs.

[3], [4], [5]

Deformation of the gallbladder in adults

Deformation of the gallbladder in adults can occur as a result of chronic cholecystitis (both acute and chronic), as well as after Botkin's disease (hepatitis A). If an adult is found to have a deformity, it is entirely possible that she is congenital, simply the patient has never previously been examined for bile duct disease.

Such a change in the body may not manifest itself at all and can be detected by chance, or be distinguished by a common standard symptomatology:

• attacks of nausea and vomiting;
• soreness in the epigastric region and right hypochondrium;
• flatulence;
• increased sweating;
• Stool disorder (constipation or diarrhea).

If there is constipation, then this may already be an indirect sign of the inflammatory process in the gallbladder, or calculous cholecystitis (the formation of stones in the organ). In the presence of symptoms, the disease is subject to mandatory treatment. Asymptomatic deformity is observed by a doctor, with periodic prophylactic ultrasound control.

[6], [7], [8], [9], [10]

Deformity of the gallbladder in children

Recently, medical specialists often register deformations of the gall bladder in children. Especially often the disease occurs in adolescence, when due to prolonged stagnant phenomena, simultaneously with active growth of the body, an acute inflammatory process develops. Starting point for deformation of the gallbladder can be dyskinesia of the bile ducts, or the formation of sand or stone-like deposits in the biliary system.

If the deformity of the gallbladder in a child is not associated with a hereditary predisposition or congenital pathology, we can distinguish the following most common causes of deformation:

• inflammatory diseases of the digestive tract;
• various diseases of the biliary system;
• stasis or violation of outflow of bile.

Most often the child complains of dull aching pain under the ribs to the right, loss of appetite, taste of bitterness in the oral cavity, periodic eructations ("empty" or with the smell of rotten eggs), bouts of nausea. Painful syndrome can be associated with eating, especially fatty, fried, spicy dishes, as well as overeating and increased physical activity.

In an acute period of the disease there may be signs of intoxication: joint pain, fatigue, high temperature indices, gray or yellowish-gray hue of the face, headaches. If you find these symptoms, you need an emergency doctor.

[11]

Deformation of the gallbladder in a newborn

Deformation of the gallbladder in a newborn, as a rule, is inherent in nature. Often cases where pathology occurs in some members of the same family and close relatives: brothers and sisters, parents and children, etc.

If you do not take into account the hereditary factor of deformation, then the cause of the organ's shape change may be external effects on the fetus during pregnancy:

• reception of medications prohibited during pregnancy;
• the effect of nicotine (both active and passive);
• various diseases of the future mother (especially in chronic form);
• regular use of alcoholic beverages during pregnancy.

The greatest risk of harm to the child can be traced in the first trimester of pregnancy, when the digestive system of the future baby is laid). But in other periods of bearing, the danger of negative influence on the child is also present, however, to a lesser extent.

A woman who carries a baby should feel the level of responsibility that is assigned to her. This applies to her own health, and to the health of the future unborn child.

[12], [13], [14]

Consequences of gallbladder deformity

Deformation of the body is a violation of its form, therefore the consequences of the deformation of the gall bladder directly depend on the degree of shape change, on how much this change affects the functions of the gallbladder, and also on what symptomatology this process gives.

If the deformity affects the excretion of the biliary secret, then the development of biliary stasis is possible. This, in turn, can serve as a good soil for the formation of an inflammatory reaction in the organ, with the further formation of stones in the gallbladder. Bile stasis may appear as a result of folds and bends in the bladder.

Full bend and twisting of the bladder can provoke a prolonged circulatory disorder in the bile excretory organs. With the passage of time, this process can go to necrosis (necrosis) of the bladder tissues, perforation of its walls and the exit of the biliary secretion directly into the abdominal cavity. As a result, bile peritonitis develops - the inflammatory process of the visceral and parietal peritoneum, which occurs against a background of considerable intoxication and pronounced disturbances of homeostasis, with a breakdown in the functions of all organs and systems. If the peritonitis does not provide immediate relief, the outcome can be lethal.

However, fortunately, the effects of gallbladder deformations are not always so dramatic. For example, labile deformity of the gallbladder often passes without a trace, without requiring any additional treatment. Congenital deformation of the gallbladder can also disappear on its own: in some cases, the child simply "outgrows" the pathology, and when performing ultrasound at an older age, parents are surprised to note the disappearance of the deformity.

Whatever it was, any deformation of the body requires regular monitoring by the doctor. At the slightest suspicion of aggravation of the process, the doctor will be able to take appropriate measures in time and prescribe a treatment to avoid further adverse consequences and complications.

[15]

Ultrasonography of the gallbladder

The ultrasonic method of diagnosis is the most informative and popular technique for examining the organs of the abdominal cavity. With the help of this method, it is possible to significantly speed up the detection of the disease and, accordingly, to prescribe the necessary treatment more quickly. The absence of harm in the use of ultrasound diagnostics makes it possible to apply the method unhindered in pregnant women and even young children.

Ultrasound technology can determine the deformation of the gallbladder and the compaction of its walls. However, no less common method of computed tomography in the vast majority of cases, these changes do not reveal.

Ultrasonography of the gallbladder can be considered in different angles. For example, often the bile of the gallbladder is unstable and may disappear when examining the patient in a standing position or with a tense stomach. Sometimes such manipulations, on the contrary, can lead to the appearance of bends. For these reasons, ultrasound diagnostics are recommended to be carried out in different positions and positions.

Planning an ultrasound diagnosis, it should be borne in mind that the correct "reading" of the image depends to a large extent on the qualification of the specialist and his literacy, as well as on the quality of the equipment used.

Echoes of deformity of the gallbladder

Ultrasonic diagnosis of the gallbladder and ducts is considered the most informative method, which is absolutely harmless and allows you to examine several internal organs, for example, the zone of the liver and kidneys.

Examination of bile excretory organs is carried out with suspicion of inflammation, formation of gallstones, tumor development, and also with unexplained cause of jaundice.

When examining the bile excretory organs, attention is drawn to the position of the organ, its shape, dimensions, movements during breathing, external and internal outlines, density and structure of the walls, the presence of auxiliary inclusions, the degree of filling and release of the bladder.

A normal gallbladder is defined as an echo-negative structure located on the dorsal side of the right hepatic lobe. The bottom of the bladder should protrude 10-15 mm from the lower edge of the liver. The size of the biliary organ is normal: length - from 70 to 100 mm, width - from 30 to 40 mm. The form is oblong pear-shaped, oval or round, with clear and even outlines.

With an inflammatory reaction in the gallbladder, the wall of the organ thickens and thickens, which is determined by the strengthening of the echostructure. Echoes of deformity of the gallbladder are also noticeable: bends, wall retraction and a clearly expressed violation of the shape and shape of the organ are detected.

With the presence of stone formation in the cavity of the bladder against the background of the echonegative structure of the bile secret, an intensified echo signal is found which directly corresponds to the location of the deposit. When you change the position of the trunk, the stone can change its location inside the bladder.

[16], [17], [18],

Treatment of gallbladder deformity

Congenital changes in the shape of the gallbladder, if it does not cause any problems, does not require special treatment.

For patients with acquired deformity, accompanied by painful symptoms, treatment is compulsory. Moreover, they often prescribe 3-4 courses of therapy for 10-14 days. The main direction of such treatment is to restore the bile excretion, to remove the pain syndrome, to stop the inflammatory reaction. What is the basis for treatment of gallbladder deformity:

• adherence to bed rest in an acute period;
• reception of a sufficient amount of liquid (mineral water is not recommended);
• adherence to a special diet (see below);
• taking antispasmodics and analgesics. In the acute period, injectable intramuscular injection of drotaverine (no-shpy), baralgina, etc. Is recommended. In cholelithiasis and development of colic, the administration of atropine sulfate 0.1% is recommended. In a more severe course, tramadol is used;
• reception of antibacterial preparations of a broad antimicrobial spectrum (cephalosporin antibiotics, ampicillin, augmentin, etc., concomitantly with antifungal treatment and probiotic drugs);
• if there are signs of intoxication, detoxification treatment is carried out;
• reception of cholagogue means - after cupping of the acute period and after antibiotic therapy, in the absence of stones in the gallbladder. Of the cholagogue preparations, hepabene, tsikvalon, flamin, claston, nicodine, oxyphenamide;
• strengthening of immune defense with the help of vitamin preparations: retinol acetate, tocopherol, ascorbic acid, vitamins of group B;
• physiotherapy (electrophoresis with novocaine and ultrasound), phytotherapy, only during remission;
• LFK, massage of the abdominal region - facilitates the excretion of bile, reduces the risk of stone formation. It is important not to allow excessive physical exertion, weight bearing and sharp motor activity, as this can help to twist the bubble along the longitudinal axis.

At a congenital excess of a cholic bubble at the child often do not resort to any treatment. If nothing disturbs, the state of the gall bladder is simply observed. In some cases, the baby "overgrows" the pathology, and the gallbladder acquires an acceptable shape. But often a person can live with deformation all his life and not even suspect about the presence of a defect.

Of course, the deterioration of the situation with deformed gall bladder is better to provide in advance. For this reason, experts recommend that parents of children with deformity adhere to the rule of three "F": this means that the child is not allowed to eat Fried dishes, Fat dishes and egg yolk. If the baby begins to complain of pain in the tummy, a bad taste in the mouth, then you can not ignore such symptoms, you should always consult a doctor.

How to treat gallbladder deformity?

If there are no complications, then you can try to treat the deformity of the gallbladder with the help of phytotherapy, or alternative methods. Mostly, they use herbal infusions that have choleretic, bile-forming, anti-inflammatory and calming ability. Phytotherapy should be continuous and continuous, for two to three months.

Recommended use of the following herbal mixtures:

• cumin 1 teaspoon, buckthorn 3 tsp, marshmallow 3 tsp, mint 3 tsp, sage 3 tsp. The mixture is brewed with boiling water in a thermos bottle (1 L), in the evening, 200-300 ml is drunk;
• buckthorn 2 tsp, mint 2 tsp, celandine 1.5 tsp, St. John's wort 3 tsp. Brewed with boiling water in a thermos (1 liter), drink in a day for 200-600 ml per day;
• lemon balm 3 tsp, mint 3 tsp, chamomile 3 tsp. Brew with boiling water in a thermos. Drink during the day 250 ml in three divided doses.

If there is gallstone disease or digestive disorders against the background of deformation, then the following collection can be prepared: 1 tsp. Chamomile, 1 tsp. Buckthorn, 1 tsp. Fennel, 2 tsp. Immortelle, 2 tsp. Mint, 2 tsp. Yarrow, 2 tsp. Bitter wormwood. Brewed in 1 liter of boiling water, drink 200 ml twice a day for half an hour before meals.

With exacerbation of cholecystitis, tea is made with the addition of mint, dandelion root, madder root, dyeing, buckthorn bark.

Eliminate the pain and calm the irritated gallbladder tea from celandine and mint, as well as decoction of tansy or St. John's wort.

Eating with gallbladder deformity

Nutrition with a deformation of the gallbladder can be described in the table:

	Allowed	You can not
Bakery products.	Bread from a dark flour, preferably the day before yesterday's baking or pasted, pasta.	Bread of fresh baking, baking, puff, fried dough, pancakes, pies, cake.
First meal.	Grounded soups from cereals and vegetables, without meat, yolks and green onions, without roasting.	Meat, mushroom and fish broth.
Snacks.	Vegetables or fruit salads, vinaigrette, brawny vegetables, dairy diet sausage, low-fat and low-fat cheeses.	Pickles, spicy and fatty, canned foods, smoked products, caviar.
Meat products.	Low-fat grated boiled or steamed meat, you can in the form of cabbage rolls, teftelek in a double boiler.	Fatty parts of meat and fat, by-products.
Fish products.	Low-fat fish in boiled and baked form.	Fatty fish dishes, as well as fried, smoked and salted.
Eggs.	Steam protein omelet.	Yolk, fried eggs.
Milk products.	Fresh milk up to 2.5% fat content, curdled milk, kefir, low-fat sour cream, low-fat cottage cheese.	Cream, fatty milk products.
Cereals and pasta.	Any.
Vegetables.	Practically everything.	Sorrel, radish, green onions, garlic, vegetables in marinade.
Beans.	Green peas in the form of mashed potatoes.	Beans, lentils, peas.
Fruit and berry dishes.	Non-acidic, in fresh, boiled and baked form, and also dried fruits.	Sour fruits and berries.
Dessert.	Kissel, compote, souffle, jelly, marmalade, marshmallow, honey, homemade jam.	Products with chocolate, cream. Ice cream.
Oils.	Butter in small quantities, vegetable refined oil.	Refractory fat, bacon.
Beverages.	Incomplete tea and coffee with milk, compote, freshly squeezed juice.	Cold drinks, soda, instant coffee, cocoa.
Spices and sauces.	Home-made sauce on sour cream, milk, vegetable broth. Fruit syrups. Greens, vanillin, cinnamon.	Spicy spices, industrial mayonnaise, ketchup.

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Diet with gallbladder deformity

A strict diet for the deformation of the gall bladder only affects the period of exacerbation. During the remission, the menu can be expanded, while at the same time listening to your body and its reaction to the use of a particular product. It is important to remember the basic rules of dietary nutrition:

• It is necessary to forget about spicy, fried and sour food;
• all foods should be eaten raw, boiled, steamed or baked;
• it is not recommended to eat cold and too hot food. The optimum temperature of food is from +15 to +60 ° C;
• Eat should be 5-6 times a day in small portions;
• in the intervals between meals should drink enough water - 2-2.5 liters per day.

Egg yolk, offal, broths from meat, fish and mushrooms, animal fat and sauces worsen the function of the liver and overload the gallbladder, so it is better to abstain from using them.

In no case should you tolerate overeating, since it is a very heavy burden on the entire digestive system, and on the gall bladder in particular. In time, break the meal: it is better to eat less, but more often.

Deformation of the gallbladder does not always require treatment, but constant monitoring of the condition of the body is necessary. Diet, controlled physical activity, lack of stress - all these recommendations can permanently protect you from manifestations of deformation and protect against possible unpleasant consequences of this defect.

[20],