Gallbladder kink

Kinking of the gallbladder is one of the most common pathologies of this human organ. The natural, anatomically determined shape of the gallbladder is deformed when it is kinked, which can lead to functional disorders, in particular, decreased motility of the biliary tract.

Taking into account the main factors of pathogenesis, clinical medicine distinguishes between congenital (true and acquired forms). There is also a diagnostic division of this pathology - depending on which specific sections of the gallbladder have been deformed.

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Causes of gallbladder kinking: congenital and acquired

The causes of the gallbladder kink that occurs during embryonic development are associated with a disruption in the formation of this organ, which occurs in the fifth week of pregnancy (simultaneously with the formation of the liver, bile ducts and duodenum). The future gallbladder is formed by strands of glandular epithelial cells of the abdominal (ventral) part of the embryo - from a common diverticulum with the liver. The fetus is most sensitive to various adverse effects on the formation of the biliary system during this period. And it is at this stage that a congenital kink of the gallbladder can be "laid down", associated with a violation of proportions during the growth of the organ.

The disease of this etiology is most often permanent, which doctors define as either a persistent or a fixed bend of the gallbladder. But, since the bladder is a hollow organ with a muscular membrane (that is, quite mobile), the deformation can change its location and shape. And then the so-called labile bend of the gallbladder is diagnosed.

Acquired kink of the gallbladder in an adult can be a consequence of reasons such as:

• enlargement of the gallbladder, liver, or right kidney;
• increased mobility of the gallbladder (due to its atypical location outside the right longitudinal groove on the lower surface of the liver);
• constant violation of the diet (alternating prolonged fasting and overeating);
• lifting heavy objects, sudden movements or sitting for a long time (functional kink of the gallbladder);
• significant prolapse of internal organs relative to the anatomical norm in old age (physiological bending of the gallbladder);
• obesity.

In this case, the bend can occur in different parts of the bladder - in the area of its body, bottom or neck. And by localization, when conducting diagnostics, gastroenterologists distinguish between the bend of the lower third of the gallbladder, the upper third, bottom, wall and duct of the gallbladder. More often than other varieties, the bend of the neck of the gallbladder is diagnosed, and the most dangerous consequences are caused by the bend of the gallbladder in the body.

By the way, the forms taken by the gallbladder as a result of deformation are very diverse and depend on the location and degree of pathology. Thus, it can be a hook-shaped bend, an arc-shaped bend, or an hourglass-shaped bend. Moreover, there can be a double bend of the gallbladder, which doctors define as S-shaped and consider it the main cause of biliary dyskinesia in young children.

In rare cases, a woman may develop a kink in the gallbladder during pregnancy - when the uterus increases to such a size that it begins to "squeeze" the liver and gallbladder. But more often, this is simply a congenital pathology that did not bother the patient in any way and was detected only during the woman's examination regarding pregnancy.

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Symptoms of a kink in the gallbladder

In most clinical cases, there are no symptoms of gallbladder kinking. However, when the degree of deformation of this organ is significant, the signs of pathology appear as:

• attacks of nausea accompanied by vomiting;
• a bitter taste in the mouth (due to the reflux of bile into the stomach);
• heartburn and belching;
• heaviness in the stomach and bloating;
• pain in the right hypochondrium or epigastrium;
• increased sweating;
• constipation or diarrhea;
• decreased or complete loss of appetite.

Pain caused by a kinked gallbladder is defined as aching or dull (often bursting in nature) and can radiate to the shoulder blade (on the right), spine, or to the area of the right collarbone.

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Kinked gallbladder in a child

The kink of the gallbladder in a newborn is certainly congenital, and the details of the occurrence of this pathology were discussed earlier.

With a more pronounced pathology, symptoms may appear - in the form of a baby crying after breastfeeding, or when the child begins to be given complementary foods. Children after 2-3 years may complain of abdominal pain or nausea after eating, there may be vomiting or diarrhea. Parents should not delay contacting a doctor, since the degree of deformation of the gallbladder can be quite significant. And the violation of the outflow of bile affects not only the child's well-being, but also the metabolism in his body.

According to pediatricians, a minor kink in the gallbladder in a child may not manifest itself in any way either in childhood or with age.

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Consequences of a kink in the gallbladder

The consequences of a kinked gallbladder are that bile (necessary for the digestion process) can accumulate and stagnate. On the one hand, this leads to incomplete breakdown of fats that enter the body with food. As a result, the content of fatty acids in the blood increases, and this, in turn, reduces the activity of glucose utilization and oxidation. In this "scenario", there is a high probability of a decrease in the body's tolerance to carbohydrates and the development of diabetes, as well as the deposition of unsplit lipoproteins in fat depots - that is, obesity. In addition, impaired fat absorption over a long period of time leads to a deficiency of fat-soluble vitamins (A, D, E and K), which is expressed in deterioration of vision, weakening of muscle contractility (including the myocardium), decreased elasticity of blood vessels, etc.

On the other hand, the kink of the gallbladder creates all the conditions for the development of inflammatory diseases (most often chronic cholecystitis), as well as the formation of stones in the gallbladder, which results in cholelithiasis or calculous cholecystitis.

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Diagnosis of gallbladder kinking

The main method used to diagnose gallbladder kinking is ultrasound (synonyms: echography, sonography). Ultrasound allows not only to determine the functional state of the organ and the exact localization of the pathology, but also to examine its walls, neck and duct areas.

As experts note, it is not so easy to determine the causes of the gallbladder kink during its ultrasound examination. To determine the nature of the pathology (congenital or acquired), the ultrasound is first done before and then after taking egg yolks, which cause increased secretion of bile. When the gallbladder kink is congenital, the deformation of the organ remains unchanged.

Echo signs of a kink in the gallbladder (or echographic symptoms) during longitudinal and transverse scanning of the organ on a linear-type device are expressed in the fact that the image clearly shows a change in the normal shape of the organ in the form of echo-positive linear formations of various localizations. Most often, the kink is recorded at the transition point of the bladder body to the neck. In this case, the bile located in the bladder has the appearance of an echo-negative formation.

In addition, during the study of gallbladder motility, the presence and degree of biliary dyskinesia is determined, which occurs in 80% of cases of gallbladder kinking.

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Treatment of gallbladder kinking

If a congenital kink of the gallbladder does not reveal itself in any way, then a person can live with it all his life and discover pathologies by chance - during an ultrasound examination for a completely different reason. In such cases, treatment of the kink of the gallbladder is not carried out. Moreover, the treatment itself is aimed not at the cause, but at the symptoms.

If there are signs and the diagnosis is confirmed, treatment for a kink in the gallbladder includes taking medications and following a gentle diet.

Gastroenterologists most often prescribe choleretic drugs when the gallbladder is kinked.

The drug Flamin in tablet form is used as a choleretic agent for many pathologies of the gallbladder. Its active ingredient is purified polyphenolic flavonoids and glycosides of the medicinal plant immortelle arenarium. Prescribed one tablet (0.05 g) three times a day - a day 30 minutes before meals, washed down with 100 ml of warm boiled water. Children 3-7 years old should take half a tablet three times a day, children 7-12 years old - three quarters of a tablet, over 12 years old - the dosage is the same as for adults. The course of treatment is from 10 to 40 days (determined by the attending physician, taking into account the severity of the symptoms of the kink of the gallbladder).

The choleretic agent Odeston (synonyms - Himekromon, Cantabilin, Adesin C, Cholestil, Gimekromon) not only accelerates the evacuation of bile into the intestinal lumen, but also relieves spasm of the bile ducts. This drug is prescribed in a dosage of: one tablet (0.2 g) three times a day half an hour before meals. The duration of the course of therapy is two weeks. The use of Odeston can cause side effects: diarrhea, urticaria, headaches and pain in the epigastric region, ulceration of the gastrointestinal tract and flatulence. Contraindications to the use of this drug are: childhood, pregnancy and lactation, liver and kidney failure, gallbladder obstruction, ulcerative diseases of the gastrointestinal tract, Crohn's disease, hemophilia.

The combined drug Aristochol (alcohol extract in vials) contains alcoholic extracts of yarrow, celandine, wormwood, dandelion roots, cat's foot fruits and milk thistle. Their combined effect is aimed at emptying the gallbladder and relieving spasms. In addition, in case of constipation, Aristochol acts as a laxative. It is prescribed only to adults - 20-25 drops in a small amount of water 2-3 times a day (after meals).

The drug Hofitol for gallbladder kinking, which has a choleretic and hepatoprotective effect and is often prescribed for the treatment of this pathology in children. The active component of this drug is a dry aqueous extract from the leaves of the field artichoke. Hofitol tablets are taken by adults and children over 12 years old - 1-2 tablets three times a day (before meals); children 6-12 years old - one tablet. The course of treatment is 2-3 weeks.

Hofitol in solution form is prescribed orally 2.5-3 ml three times a day (before meals); children under 12 years of age are prescribed a quarter or half of the adult dose (as prescribed by the doctor). The side effect of long-term use of this drug is diarrhea. And among the contraindications are: obstruction of the bile ducts, acute inflammatory diseases of the kidneys, liver and bile ducts, liver failure, and the presence of stones in the gallbladder.

The synthetic choleretic agent Tsikvalon (synonyms - Beveno, Flavugal, Vanilon, Divanil, Divanon) in the form of 0.1 g tablets helps relieve symptoms of a kink in the gallbladder. Doctors prescribe 0.3 g per day (3 tablets) for the first two days of treatment. Then take one tablet 4 times a day. The course of treatment lasts 3-4 weeks. Before repeating the course, a break of 30 days is required.

Contraindications to Tsikvalon include individual hypersensitivity, acute hepatitis, bile duct obstruction, gastric ulcer and duodenal ulcer, and liver cirrhosis. Side effects include a feeling of pressure in the liver and gallbladder and increased bitterness in the mouth.

Treatment of gallbladder kinking with herbs

The most popular and affordable herbal remedy for treating a kinked gallbladder is the pharmaceutical Choleretic Collection No. 3. It contains medicinal plants such as chamomile flowers, calendula and tansy, peppermint leaves and yarrow herb.

The decoction is prepared in a water bath for 10-15 minutes at the rate of 2 tablespoons of the collection per glass of boiling water. For use, the resulting decoction must be diluted with boiled water to the original volume - 200 ml.

The decoction should be drunk one third of a glass at least three times a day - half an hour before meals (shake the decoction before taking). The maximum duration of the course of treatment is a month. In case of calculous cholecystitis, pregnancy and lactation, as well as children under 12 years of age, this remedy is prohibited. Possible side effects are heartburn and allergic reactions.

Diet for a kinked gallbladder

To alleviate the main symptoms of this pathology, gastroenterologists recommend adhering to the principles of therapeutic nutrition. A diet for a kinked gallbladder involves eating small amounts of food at least 5 times a day (with 4-hour breaks between each meal).

It is necessary to exclude from the diet:

• fatty, fried, smoked and spicy;
• spices and seasonings;
• canned goods and snacks;
• legumes and whole grains;
• grapes, raisins, dried apricots and apricots;
• carbonated drinks and alcohol.

The following are subject to restrictions: salt, butter, chocolate, coffee, cocoa, honey, sugar, jam.

You can eat lean meat and poultry, fish, seafood, vegetables and fruits (not sour), cereals, pasta, fermented milk products, vegetable oil (refined). And in the culinary preparation of dishes, boiling, baking and steaming should be used.

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Gymnastics for a kinked gallbladder

With the right exercises, gymnastics for a kinked gallbladder can become not only a therapeutic measure, but also a preventive measure to prevent the condition from getting worse. Although all gastroenterologists agree that preventing a kinked gallbladder is impossible by definition (of course, if we are talking about congenital pathology).

To improve the functioning of the gallbladder, it is recommended to perform the following exercises when the gallbladder is bent:

• Exercise 1

Starting position: lying on your stomach, arms extended along your body, feet resting with toes on the floor. As you exhale, simultaneously lift your head, chest, arms and legs (straight at the knees) off the floor. You need to hold the pose for a few seconds, but do not hold your breath. Then slowly, as you exhale, return to the starting position. Do 5-6 times.

• Exercise 2

Starting position: lying on your back, straight arms extended behind your head, lower back pressed to the floor. As you exhale, lift your straight legs 20 cm from the floor and hold for 3-5 seconds, then lift your legs higher – 50 cm from the floor and also hold for 5 seconds (do not hold your breath). As you exhale, slowly lower your legs and relax. Repeat 4 times.

• Exercise 3

Starting position: lying on your back, legs straight, arms extended along the body.

Take a deep breath, hold your breath for 3 seconds, and then slowly exhale the air, “squeezing” it out, while straining the muscles of the abdominal wall. Repeat 8-10 times.

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Gallbladder kink prognosis

The prognosis for gallbladder kinking is unfavorable only in one case. When this pathology completely blocks the outflow of bile. As a result, a rupture of the gallbladder wall may occur. And then the gallbladder is removed surgically.

Qualified medical care, proper nutrition, feasible physical activity and a positive emotional attitude will help to avoid biliary dyskinesia or chronic cholecystitis, which are usually threatened by a kink in the gallbladder.

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