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Gallbladder
Last reviewed: 23.04.2024
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The gallbladder (vesica biliaris, s.vesica fellea) has a pear-shaped form, in it bile accumulates and concentrates. The gallbladder is located in the right hypochondrium. Its upper surface is located in the pit of the gallbladder on the visceral surface of the liver. The free lower surface faces the peritoneal cavity, is covered by the peritoneum and is attached to the anterior wall of the upper part of the duodenum. To the right of the lower surface of the gallbladder is the right bend of the colon. The shape of the gallbladder resembles a pear. The length of the gall bladder is 8-12 cm, width - 4-5 cm, capacity - about 40 cm 3. The gall bladder is divided into 3 sections: the bottom, the body and the neck.
The bottom of the gallbladder (fundus vesicae biliaris) is enlarged. It slightly comes out from under the lower edge of the liver at the level of joint VIII and IX costal cartilage, which corresponds to the intersection of the costal arch with the right edge of the rectus abdominis muscle. The bottom of the gallbladder passes into the body (corpus vesicae biliaris), and the body - into the neck (collum vesicae biliaris). From the cervix begins the bladder duct (ductus cysticus). The cervix of the bladder is directed toward the gates of the liver and, together with the bladder duct, is located in the thickness of the hepatic-duodenum ligament. At the site of the transition of the body of the gall bladder to its neck, a bend is usually formed. Therefore, the cervix is at an angle to the body of the gallbladder.
The wall of the gallbladder is formed by four layers: the mucosa, the muscular and serous membranes and under the mucous base. The mucous membrane is thin, forming numerous small folds. In the neck area, a spiral fold is formed (plica spiralis).
The mucous membrane of the gallbladder is lined with a single row cylindrical epithelium. In a well developed lamina of the mucous membrane there are lymphocytes and their small clusters, mucous glands, vessels and nerves. The submucosa is thin. The muscular membrane of the gallbladder is formed by a single circular layer of smooth myocytes, among which there are muscle beams of oblique and longitudinal orientation. The muscular layer is less developed in the bottom region, more strongly in the neck region, where it directly extends into the muscular layer of the cystic duct. Outside the muscle shell is located
Subservoir base
(tela subserosa) and
Serous
Membrane (peritoneum). The peritoneum covers the gallbladder from below and from the sides. The surface of the gallbladder, facing the liver, is covered with adventitia.
Innervation of the gallbladder: branches of the vagus nerves and the hepatic plexus (sympathetic).
Blood supply of the gallbladder: the bile duct artery (from its own hepatic artery).
Venous outflow: the biliary duct (influx of portal vein).
Outflow of lymph: liver and biliary lymph nodes.
[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12]
Age features of the gallbladder
The gall bladder in the newborn is elongated (3-4 cm), but its bottom does not protrude from under the lower edge of the liver. By 10-12 years, the length of the gall bladder increases approximately 2 times. The gallbladder is projected onto the anterior abdominal wall below the costal arch, 2 cm to the right of the anterior median line. The duodenum, the mesenteric lobes of the small intestine and the transverse colon are located from the gallbladder. The final size of the gallbladder acquires to 20-25 years. In the elderly, there are local thinning of the walls of the gallbladder, coiling of its walls is formed (especially over the area of its neck).
