Physical and chemical properties of bile

The color of bile is normal: portions A - golden yellow, amber; B - saturated yellow, dark olive, brown; C - light yellow.

• Changing the color of portion A: dark yellow - when bile is thrown portion B and with hemolytic jaundice; light yellow - with
  parenchyma of the liver, viral hepatitis, cirrhosis of the liver, obstruction of the sphincter of Odd with a stone, compression of the enlarged pancreas head, spasm of the sphincter; staining with blood - with peptic ulcer of duodenum, fetal nipple tumor, hemorrhagic diathesis; greenish color (transparent bile) - with stagnation or infection.
• Changing the color of portion B: a weak color (white bile) - with chronic inflammatory processes with atrophy of the mucous membrane of the bladder; very dark coloration - with pathological thickening of bile in the bladder (stagnation) and with hemolytic conditions.
• Change in color of portion C: pale coloration - with viral hepatitis, liver cirrhosis; dark color (pleochromia) - with hemolytic jaundice; green coloration - with inflammatory processes of bile ducts, cholangitis (due to oxidation of bilirubin in biliverdin), red color - from blood admixture in peptic ulcer of duodenum, malignant neoplasms of the pancreas, pyloric stomach.

Transparency. Normally, all portions of bile are transparent. A small, immediately apparent uniform turbidity is associated with an admixture of hydrochloric acid and does not indicate the presence of inflammatory changes. The turbidity of portion A is possible with increased acidity of gastric juice, pyloric insufficiency or duodenal reflux; Flakes are detected with duodenitis. The turbidity of portion B is possible with inflammatory processes in the gallbladder. Slime flakes fall in portion C in inflammatory processes of intrahepatic strokes, cholecystocholangitis.

Reaction. Normally, Serving A has a neutral or basic reaction; portions B and C are basic. Acid reaction of portion A is possible with an inflammatory process in the duodenum. Acid reaction of portion B is characteristic for inflammation of the gallbladder, and other portions for inflammatory processes in the corresponding sections of the bile ducts.

Density. Normally, the relative density of portion A is 1.003-1.016; B - 1.016-1.032; C - 1.007-1.011.

• The relative density of portion A increases when the portion B is thrown away, with hemolytic jaundice, decreases when the liver function is impaired, the parenchyma of the liver is damaged (viral hepatitis, cirrhosis), and the bile enters the duodenum.
• The relative density of portion B increases with congestion of bile (stasis), cholelithiasis, with dyskinesia of biliary tract; It decreases with a decrease in the concentration capacity of the gallbladder.
• The relative density of portion C increases with hemolytic jaundice, decreases with a decrease in bilirubin secretion (hepatitis, cirrhosis of the liver).

Hydrochloric acid. In a healthy person, the content of bile acids in portion A is 17.4-52 mmol / l, in portion B - 57.2-184.6 mmol / l, in portion C - 13-57.2 mmol / l. An increase in the concentration of bile acids in portion C is observed with increased secretion of cholic acid by the hepatic cells, a decrease in secretory deficiency of the hepatic cells.

Cholesterol. In a healthy person, the concentration of cholesterol in bile in portion A is 1.3-2.8 mmol / l, in portion B - 5.2-15.6 mmol / l, in C-1.1-3.1 mmol / l. An increase in the concentration of cholesterol in portions A and B is noted in cholelithiasis, cholecystitis; Reduction - with a violation of the concentration capacity of the gallbladder.

Bilirubin.

Reference concentrations of bilirubin in various portions of bile

Portion of bile	Van den Bergh's method, g / l	Method of Jendrashek, mmol / l
A AT FROM	Up to 0,25 Up to 2-4 Up to 0,25	0.17-0.34 6-8 0.17-0.34

The concentration of bilirubin in bile decreases with mechanical jaundice, viral hepatitis, liver cirrhosis, calculous cholecystitis, increases with hemolytic jaundice, Addison-Birmer anemia, malaria.

[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11]