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QUIZ – Gall Bladder

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The gallbladder is a small pouch that sits just under the liver and stores bile produced by the 1) ___. After meals, the gallbladder is empty and flat, like a deflated balloon. Before a meal, the gallbladder may be full of bile and about the size of a small pear. In response to signals, the gallbladder squeezes stored 2) ___ into the small intestine through a series of tubes called ducts. Bile helps digest fats, but the gallbladder itself is not essential. Removing the gallbladder in an otherwise healthy individual typically causes no observable problems with health or digestion yet there may be a small risk of diarrhea and fat malabsorption. For unclear reasons, substances in bile can crystallize in the gallbladder, forming gallstones. Common and usually harmless, 3) ___ can sometimes cause pain, nausea, or inflammation. t’s not clear what causes gallstones to form. Doctors think gallstones may result when your bile contains too much cholesterol. Normally, bile contains enough chemicals to dissolve the cholesterol excreted by the liver. But if the liver excretes more cholesterol than the bile can dissolve, the excess cholesterol may form into crystals and eventually into stones. Too much bilirubin may be another cause of gallstones. Bilirubin is a chemical that’s produced when the body breaks down red blood cells. Certain conditions cause the liver to make too much bilirubin, including liver cirrhosis, biliary tract infections and certain blood disorders. The excess bilirubin contributes to gallstone formation. If the gallbladder doesn’t empty completely or often enough, bile may become very concentrated, contributing to the formation of gallstones.


Inflammation of the gallbladder is called cholecystitis, and is often due to a gallstone in the gallbladder. Cholecystitis causes severe pain and fever, and can require surgery when 4) ___ continues or recurs. Although rare, 5) ___ of the gallbladder can affect the gallbladder. It is difficult to diagnose and usually found at late stages when symptoms appear. Symptoms may resemble those of gallstones. An impacted gallstone can block the ducts that drain the pancreas. Inflammation of the pancreas, or pancreatitis, is the result, a serious condition. Abdominal ultrasound is a noninvasive diagnostic test in which a probe on the skin bounces high-frequency sound waves off structures in the belly. Abdominal 6) ___ is an excellent test for gallstones and to check the gallbladder wall. In a nuclear medicine test, called HIDA scan or cholescintigraphy, radioactive dye is injected 7) ___ intravenously and is secreted into the bile. Cholecystitis is likely if the scan shows bile doesn’t make it from the liver into the gallbladder.


Using a flexible tube inserted through the mouth, through the stomach, and into the small intestine, a doctor can see through the tube and inject dye into the bile system ducts. Tiny surgical tools can be used to treat some gallstone conditions during ERCP. ERCP stands for: Endoscopic Retrograde Cholangiopancreatography. Magnetic resonance cholangiopancreatography (MRCP) is also a good diagnostic tool: An MRI scanner provides high-resolution images of the bile ducts, pancreas, and gallbladder. MRCP images help guide further tests and treatments. Endoscopic ultrasound is another helpful diagnostic, in which a tiny ultrasound 8) ___ probe on the end of a flexible tube is inserted through the mouth to the intestines. Endoscopic ultrasound can help detect choledocholithiasis and gallstone pancreatitis. Although they may be used to look for other problems in the abdomen, X-rays generally cannot diagnose gallbladder disease. However, X-rays may be able to detect gallstones.


During gallbladder surgery (cholecystectomy), a surgeon removes the gallbladder, using either laparoscopy (several small cuts) or laparotomy (traditional “open“ surgery with a larger incision). Infection may be present during cholecystitis. Though antibiotics don’t typically cure cholecystitis, they can prevent an 9) ___infection from spreading. After surgery for gallbladder cancer, chemotherapy and radiation may be used to help prevent cancer from returning. An oral medication, ursodeoxycholic acid is for people with problems from gallstones who are not good candidates for 10) ___surgery, this oral medicine is an option. Ursodeoxycholic acid may help dissolve small cholesterol gallstones and reduce symptoms. Another oral solution is called Chenix.


In a procedure called, extracorporeal shock-wave lithotripsy: High-energy shockwaves are projected from a machine through the abdominal wall, breaking up gallstones. Lithotripsy works best if only a few small gallstones are present. In a procedure called, contact solvent dissolution: a needle is inserted through the skin into the gallbladder, and chemicals are injected that dissolve gallstones. This technique is rarely used.

Sources: WebMD.com; MayoClinic.org; Wikipedia


ANSWERS: 1) liver; 2) bile; 3) gallstones; 4) inflammation; 5) cancer; 6) ultrasound; 7) intravenously; 8) probe; 9) infection; 10) surgery


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