GALL BLADDER – ANATOMY, LOCATION, SIZE, FUNCTION & PATHOLOGY

📍 LOCATION

• Gall bladder lies on the undersurface of the liver (inferior surface).

• Present in the right upper quadrant (RUQ) of abdomen.

• Lies along the interlobar fissure / main lobar fissure of liver.

• Attached to the visceral surface of the liver between right and quadrate lobe.

📏 SIZE

• Length: 7–10 cm

• Width: 3–4 cm

• Capacity: 30–60 ml

• Wall thickness (normal): ≤ 3 mm

• Common bile duct diameter: < 6 mm (after cholecystectomy can be up to 10 mm)

🧬 ANATOMY

The gall bladder has 3 main parts:

1️⃣ Fundus

• Rounded end

• Projects beyond the liver edge

• Lies at the level of the 9th costal cartilage

2️⃣ Body

• Middle portion

• Lies in a fossa between liver lobes

3️⃣ Neck

• Narrow part

• Continuous with cystic duct

• Contains Hartmann’s pouch (common site for stone impaction)

⚪ Cystic Duct

• Length 2–4 cm

• Has spiral valves of Heister

• Joins the common hepatic duct to form Common Bile Duct (CBD)

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🧪 FUNCTION

The gallbladder mainly manages bile storage and concentration:

⭐ 1. Stores bile

• Liver continuously produces bile

• Gall bladder stores bile till food intake

⭐ 2. Concentrates bile

• Removes water → bile becomes 5–10× more concentrated

⭐ 3. Releases bile into duodenum

• When we eat fatty food:
  → CCK hormone stimulates gall bladder contraction
  → Bile flows via CBD → Ampulla → Duodenum

• Helps in fat digestion and absorption

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⚠️ COMMON GALL BLADDER PATHOLOGIES

1️⃣ Cholelithiasis (Gall Stones)

• Most common disease

• Stones: cholesterol, pigment

• Seen on USG as:
  ✓ Hyperechoic focus
  ✓ Posterior shadowing
  ✓ Mobility with position

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2️⃣ Cholecystitis

Acute cholecystitis

• Gall bladder wall thickening > 3 mm

• Distended gall bladder

• Pericholecystic fluid

• Positive sonographic Murphy sign

Chronic cholecystitis

• Thickened fibrotic wall

• Gall bladder contracted or shrunken

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3️⃣ Gall Bladder Polyps

• Non-mobile echogenic lesions

• No shadow

• 1 cm → suspicious for malignancy

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4️⃣ Adenomyomatosis

• Hyperplastic condition

• Rokitansky–Aschoff sinuses

• Comet-tail artifact on USG

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5️⃣ Gall Bladder Carcinoma

• More common in elderly females

• Associated with gall stones

• Imaging:
  ✓ Mass replacing gall bladder
  ✓ Irregular thickening
  ✓ Liver invasion
  ✓ Lymph nodes + metastasis

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6️⃣ Biliary Dyskinesia

• Gall bladder fails to contract properly

• Diagnosed on HIDA scan (GBEF ↓)

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7️⃣ Empyema of Gall Bladder

• Pus-filled gall bladder

• Large, painful, fever

• Emergency

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8️⃣ Porcelain Gallbladder

• Calcified wall

• High risk of carcinoma