Professional Documents
Culture Documents
I. Introduction/General Information
A. Location:
1. Epigastric region
2. Right hypochondriac region
3. On inferior surface of liver
4. Between quadrate and right
lobes
B. Pear-shaped, hollow structure
Location of Gallbladder
Gallbladder
Introduction/General Information, cont.
Fundus
Introduction, continued
F. Normal measurements:
7-10 cm long
~ 6 cm diameter
30 35 cc volume
G. Body and neck directed toward porta
hepatis
Introduction, continued
I. Cystic duct:
1. joins common hepatic duct
2. superior and posterior to pylorus
of stomach
The Gallbladder and Biliary System with Pancreas
Introduction, continued
Ampulla of Vater
II. Detailed Anatomy
A. Fundus of GB:
1. may be palpated
2. in angle between lateral border of right
rectus abdominis and costal margin
3. At level of elbow
4. Most anterior visceral structure
Detailed Anatomy, cont.
B. Body of Gallbladder
1. Visceral surface of liver
2. Deep to transverse colon or hepatic
flexure of colon
3. Descending portion of duodenum
is medial
Anatomical Position of the GB
IVC
Gallbladder
Lesser Omentum
E. Neck of gallbladder
1. continuous with cystic duct
2. characterized by a spiral valve (of
Heister)
3. makes catheterization difficult
GB Anatomy
Spiral Valve
(of Heister) in
Cystic Duct
Detailed anatomy, continued
F. Hartmanns Pouch
1. Infundibulum of gallbladder
2. Lies between body and neck of
gallbladder
3. A normal variation
4. May obscure cystic duct
5. If very large, may see cystic duct arising
from pouch
Hartmanns Pouch
Hartmanns Pouch of
the Gallbladder
G. Cystic Duct
1. 3-4 cm long
2. Extends from neck of gallbladder to
common hepatic duct
3. Joins with common hepatic duct
inferior to porta hepatis
4. Spiral valve may extend into neck of
gallbladder
Cystic Duct
Detailed anatomy, continued
Epiploic foramen
Lesser peritoneal
cavity
I. CBD has:
1. hepatic artery on left and portal vein
posterior
2. descends in free margin of lesser
omentum
3. On Transverse scans:
a. CBD appears as rounded,
fluid-filled structure
b. anterior and lateral to portal
vein
Biliary tract, continued
4. On Longitudinal Scans:
1. the common hepatic duct crosses
anterior to right portal vein
2. the CBD courses inferior to head
of pancreas
Biliary tract, continued
Cystic artery
c. Superficial branch, to
peritoneal surface of GB
d. Deep branch, to hepatic
surface of GB
e. May be doubled or tripled
Blood supply, continued
Gastroduodenal
Artery
Blood supply, continued
O. Lymphatic drainage of GB
1. Terminate @ celiac nodes
2. Cystic node at neck of GB
a. Actually a hepatic node
b. Lies at junction of cystic
& common hepatic ducts
3. Other lymph vessels also drain
into hepatic nodes
III. Gallbladder Diseases
GB shows likely
sites of stone
formation/deposition
Gallbladder Diseases, continued
B. Failure to delineate GB
1. Contracted (empty) due to ingestion of
food, smoking
2. Secondary to cholecystectomy
Gallbladder Diseases, continued
C. Intraluminal defects
1. GB Carcinoma
a. US useful in diagnosis
b. mass producing thickening and
irregularity in wall
c. Calculi found frequently
Gallbladder Diseases, continued
2. Polyps of GB
a. Intraluminal echogenic projections
b. do not change position with patient
c. Must be differentiated from
septations, mucosal folds
1. septations extend across lumen
2. folds change configuration
upon inspiration
Gallbladder diseases, continued
c. As obstruction progresses,
lobulated structures visible