scholarly journals PHYSIOLOGICAL CAUSES FOR THE VARIED CHARACTER OF STASIS BILE

1921 ◽  
Vol 34 (1) ◽  
pp. 75-95 ◽  
Author(s):  
Peyton Rous ◽  
Philip D. McMaster
Keyword(s):  
Specific Gravity ◽  
Gall Bladder ◽  
Functional Activity ◽  
Bladder Wall ◽  
Clinical Consequences ◽  
Bladder Activity ◽  
Biliary Stasis ◽  
White Bile ◽  
The One ◽  
Considerable Pressure

The gall bladder and ducts exert opposite influences upon the bile. The ducts fail to concentrate and thicken it with mucus as the bladder does, but dilute it slightly with a thin secretion of their own that is colorless and devoid of cholates even when the organism is heavily jaundiced. The fluid may readily be collected into a rubber bag connected with an isolated duct segment. It continues to be formed against a considerable pressure, and, in the dog, is slightly alkaline to litmus, clear, almost watery, practically devoid of cholesterol, and of low specific gravity to judge from the one specimen tested. In obstructed ducts separated from the gall bladder, or connecting with one so changed pathologically that the concentrating faculty has been lost, such fluid gradually replaces the small amount of bile originally pent up. It is the so called "white bile" of surgeons. When obstructed ducts connect with an approximately normal gall bladder the stasis fluid is entirely different, owing to the bladder activity. At first there accumulates in quantity a true bile much inspissated by loss of fluid through the bladder wall, darkened by a change in the pigment, and progressively thickened with bladder mucus. As time passes duct secretion mingles with the tarry accumulation and very gradually replaces it. The inspissation of the bile, as indicated by the pigment content, is at its greatest after only a day or two of stasis. The differing influences of the ducts and bladder upon the bile must obviously have much to do with the site of origin of calculi and their clinical consequences. The concentrating activity of the bladder cannot but be a potent element in the formation of stones. We have discussed these matters at some length. Intermittent biliary stasis is admittedly the principal predisposing cause of cholelithiasis; and the stasis is to be thought of as effective, in many instances at least, through the excessive biliary inspissation for which it gives opportunity. In this way a normal gall bladder can become, merely through functional activity, a menace to the organism. In patients with the tendency to stones frequent feedings may lessen the danger of their formation.

scholarly journals ON THE EXPULSION OF BILE BY THE GALL BLADDER; AND A RECIPROCAL RELATIONSHIP WITH THE SPHINCTER ACTIVITY

1926 ◽  
Vol 44 (2) ◽  
pp. 173-198 ◽  
Author(s):  
Philip D. McMaster ◽  
Robert Elman
Keyword(s):  
Gall Bladder ◽  
Biliary Tract ◽  
Common Duct ◽  
Bile Secretion ◽  
Reciprocal Relationship ◽  
Maximum Pressure ◽  
The Common ◽  
Pressure Resistance ◽  
The One ◽  
Considerable Pressure

After feeding a dog, forceful contractions of the gall bladder occur that are sufficient in strength to expel part of the contents of the viscus against a considerable pressure resistance. The pressure within the gall bladder of a healthy, unanesthetized dog fasted 24 to 48 hours is usually about equal to a column of bile 100 mm. high. After a few swallows of food there is a rapid increase in the pressure to more than 200 mm. with a gradual fall in it again, and repeated similar rises and falls occur thereafter. The gall bladder contractions responsible for these alterations are accompanied by a lessening in the resistance to the passage of bile to the intestine, a resistance which is maintained by the muscles at the lower end of the common duct. There would appear to be a reciprocal response on the part of the two structures to the one stimulus. The maximum pressure developing within the temporarily obstructed biliary tract in an animal with the gall bladder excluded about equals that of a column of bile slightly more than 300 mm. in height. The taking of food acts as a stimulus on the rate of bile secretion, but does not alter the maximum secretion pressure. When the gall bladder is connected with the duct system, obstruction does not lead until after some hours to the development of a pressure of more than 100 to 150 mm. within the biliary tract,—that is to say the pressure does not rise above the normal. Its failure to rise further is referable to the activity of the gall bladder to store and concentrate the bile as secreted. The physiological and clinical significance of these findings is discussed.

scholarly journals Patterns of Gall Bladder Wall Thickening in Dengue Fever: A Mirror of the Severity of Disease

2017 ◽  
Vol 03 (02) ◽  
pp. E76-E81 ◽  
Author(s):  
Jitendra Parmar ◽  
Chander Mohan ◽  
Maulik Vora
Keyword(s):  
Gall Bladder ◽  
Dengue Fever ◽  
Bladder Wall ◽  
Warning Signs ◽  
Severe Dengue ◽  
Wall Thickening ◽  
Severity Of Disease ◽  
Gall Bladder Wall ◽  
Track Pattern ◽  
Honeycomb Pattern

Abstract Background Dengue fever is a major public health problem with an increased incidence in recent years. Gall bladder wall thickening has been reported as one of the most common findings in dengue fever. There is a paucity of literature regarding the various patterns of gall bladder wall thickening in dengue fever and their significance in predicting the severity of disease. Methodology and Significant Findings Out of 93 seropositive patients included in the study, 54 patients with dengue fever had gall bladder wall thickening. 4 patterns of gall bladder wall thickening are demonstrated in this study. A uniform echogenic pattern in 20 patients, striated or tram track pattern in 11 patients, an asymmetric pattern in 2 patients and a honeycombing pattern in 21 patients. The range of patterns of wall thickening included normal wall thickening or uniform echogenic wall thickening in DF without warning signs, a striated or tram track pattern, and a honeycomb pattern in severe DF. Serial ultrasound done on consecutive alternate days revealed a change in the pattern of gall bladder wall thickening according to the severity of disease. Conclusion The present study revealed 4 distinct patterns of gall bladder wall thickening. The uniform echogenic pattern was found to be more prevalent in dengue fever without warning signs, while the honeycomb pattern was found to be more prevalent in severe dengue fever. A change in the pattern of gall bladder wall thickening on subsequent serial ultrasound can predict the severity of the disease.

Investigation of the association between gall bladder wall thickness and hypoalbuminaemia in dogs

2021 ◽  
Author(s):  
J. Sparago ◽  
N. Rademacher ◽  
S. Dehghanpir ◽  
J. Post ◽  
C. C. Liu ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Wall Thickness ◽  
Bladder Wall ◽  
Bladder Wall Thickness ◽  
Gall Bladder Wall

scholarly journals Evaluation of predictive factors for conversion of laparoscopic cholecystectomy

1970 ◽  
Vol 7 (1) ◽  
pp. 26-30 ◽  
Author(s):  
R Gabriel ◽  
S Kumar ◽  
A Shrestha
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Predictive Factors ◽  
Open Cholecystectomy ◽  
Abdominal Cavity ◽  
Bladder Wall ◽  
Patient Factors ◽  
College Hospital ◽  
Biliary Pain ◽  
Conversion Rates

Background: Laparoscopic cholecystectomy has now replaced open cholecystectomy for the treatment of gallbladder diseases. However, certain cases still require conversion to open procedures. This study identifies and evaluates risk factors that may predict conversion from laparoscopic to an open procedure. Objectives: To identify and evaluate the predictive factors for conversion of laparoscopic to open cholecystectomy. Materials and methods: A total of 234 Laparoscopic cholecystectomies were attempted at the Kasturba Medical College Hospital, Manipal, from January 2003 to July 2005. Of these, 61 had to be converted to open cholecystectomy. A retro and prospective analysis of different parameters, including Patient factors, Intra-operative factors and Surgeon factors were performed. Results: Sixty one (26.1%) laparoscopic cholecystectomies required conversion. Factors contributing to conversion included male sex, age group of 31-40 years, over weight and history of biliary pain within last two to four months, ultrasonography findings of multiple calculi and gall bladder wall thickness of more than 3 mm. Intraoperative gall bladder perforation with spillage of its contents in abdominal cavity and dense adhesions with difficult anatomy resulted in higher conversion rates. Surgery performed by surgeons in learning phase of laparoscopic surgery was more prone to conversion. Conclusion: Patient factors, presentation, preoperative ultrasonography findings and surgeon's experience, all contribute to the possibility of conversion of laparoscopic cholecystectomy. Knowledge of these factors may help in preinformation to patient for psychological preparations for conversion and an experienced surgeon can plan to operate on these patients. Key words: Cholecystectomy, laparoscopy, conversion. doi: 10.3126/kumj.v7i1.1761       Kathmandu University Medical Journal (2009), Vol. 7, No. 1, Issue 25, 26-30     

scholarly journals Clinicopathological correlation of 18F-FDG PET in characterizing gall bladder wall thickening

HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S711-S712
Author(s):  
K. Vishnu ◽  
V. Gupta ◽  
T.D. Yadav ◽  
B.R. Mittal ◽  
N. Kalra ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Fdg Pet ◽  
Bladder Wall ◽  
Wall Thickening ◽  
Clinicopathological Correlation ◽  
Gall Bladder Wall ◽  
18F Fdg

scholarly journals Contrast-enhanced computed tomography of the liver, gall bladder and urogenital tract in female red-eared terrapins (Trachemys scripta elegans)

2017 ◽  
Vol 62 (No. 12) ◽  
pp. 674-680 ◽  
Author(s):  
V. Sochorcova ◽  
P. Proks ◽  
E. Cermakova ◽  
Z. Knotek
Keyword(s):  
Computed Tomography ◽  
Gall Bladder ◽  
Contrast Medium ◽  
Bladder Wall ◽  
Post Contrast ◽  
Contrast Medium Administration ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography ◽  
Contrast Studies

The aim of the present study was to evaluate the feasibility of contrast-enhanced computed tomography for organ morphology and perfusion in five captive terrapins. Native scans were performed and afterwards an iodinated non-ionic contrast media was manually administered through the jugular vein catheter. Post-contrast CT scans were taken 20 (T<sub>20</sub>), 60 (T<sub>60</sub>) and 180 (T<sub>180</sub>) seconds after the contrast medium administration. Maximum contrast enhancement of the kidneys and the liver was detected at T<sub>20</sub> and T<sub>60</sub>, respectively. The gall bladder content, the urinary bladder content and ovarian follicles were all without contrast enhancement in all five terrapins. Gall bladder wall thickness was 0.9 mm in all terrapins. Enhancement of the gall bladder wall in post-contrast studies was considered excellent, good or poor in two terrapins, two terrapins and one terrapin, respectively, with a mean score of 1.8 ± 0.84 over all contrast studies. Enhancement of the ureters in post-contrast studies was considered excellent in all terrapins in all contrast studies. Peak aortic enhancement was reached 20 seconds after contrast medium administration with the peak enhancement of 213.5 ± 41 HU in four terrapins and 560 HU in one terrapin. Peak hepatic vein enhancement after contrast medium administration was recorded 20 and 60 seconds in two and three terrapins, respectively. In conclusion, contrast-enhanced computed tomography proved to be a valuable method for clinical examination of the liver, gall bladder, kidneys, ureters, urinary bladder and ovarian follicles in red-eared terrapins.

Sonographic Evidence of Ascites, Pleura-Pericardial Effusion and Gallbladder Wall Edema for Dengue Fever

2011 ◽  
Vol 26 (5) ◽  
pp. 335-341 ◽  
Author(s):  
M. Motla ◽  
S. Manaktala ◽  
V. Gupta ◽  
M. Aggarwal ◽  
S.K. Bhoi ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Pericardial Effusion ◽  
Gall Bladder ◽  
Renal Dysfunction ◽  
Dengue Fever ◽  
Bladder Wall ◽  
Gallbladder Wall ◽  
World Population ◽  
Gall Bladder Wall ◽  
The Mean

AbstractIntroduction: Radiographic findings of dengue fever have not yet been clearly elucidated in relation to clinical and serological findings, despite the fact that two-fifths of the world population lives in areas where the virus is endemic. The current study is a retrospective analyzis of ultrasonographic (USG) features of patients presenting with probable dengue fever during the outbreak of DF of 2006 in North India.Methods: Case records of a 169 patients with probable dengue fiver were included. Ten individual sonographic parameters were reviewed vis-à-vis ascites, hepatomegaly, splenomegaly, gall bladder wall edema (GBWE), pleural effusion (right or left or both), pericardial effusion, pericholecystic collection, perinephric collection. Subjects who had GB wall thickness >3 mm as measured on ultrasound were identified as positive for GBWE. The cases were analyzed in view of their serological profile.Results: The mean age of the subjects was 27.9 +/− 13.4 years. The mean value of the platelet count was 57.4 +/− 22.3 x 103/cmm. The most common ultrasonographic feature was ascites (126, 74.6%) followed by gall bladder wall edema (122, 72%), hepatomegaly (78, 46.2%), splenomegaly (66, 39.1%) and pericholecystic collection (63, 37.3%); 48 (28.4%) subjects demonstrated evidence of pleural effusion on the right side, while 19 (11.2%) had bilateral effusion. None of the subjects had an isolated left pleural effusion. Twenty-seven (16%) subjects reported bleeding manifestations in the form of petechiae and five (3%) developed renal dysfunction. Presence of pleural and pericardial effusions was found to be specific while ascites and GBWE were identified as highly sensitive markers for seropositive Primary DF.Conclusions: Ultrasonographic evidence of ascites, pleuro-pericardial effusion, and gallbladder wall edema are rapidly aquired, non-invasive markers of dengue and can be helpful before serological investigations become available. These findings may indicate severity and may herald the onset of bleeding (petechiae) or predict the development of acute renal dysfunction.

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