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Other Terms: Gall bladder, Vesica biliaris (Fellea), Vesica biliaris, Vesica fellea, Vésicule biliaire, Gallenblase, Apdo
The gall bladder is a conical or pear-shaped musculomembranous sac, lodged in a fossa on the under surface of the right lobe of the liver, and extending from near the right extremity of the porta to the anterior border of the organ. It is from 7 to 10 cm in length, 2.5 cm in breadth at its widest part, and holds from 30 to 35 cc. It is divided into a fundus, body, and neck. The fundus, or broad extremity, is directed downward, forward, and to the right, and projects beyond the anterior border of the liver; the body and neck are directed upward and backward to the left. The upper surface of the gall bladder is attached to the liver by connective tissue and vessels. The under surface is covered by peritoneum, which is reflected on to it from the surface of the liver. Occasionally the whole organ is invested by the serous membrane, and is then connected to the liver by a kind of mesentery.
The body is in relation, by its upper surface, with the liver; by its under surface, with the commencement of the transverse colon; and farther back usually with the upper end of the descending portion of the duodenum, but sometimes with the superior portion of the duodenum or pyloric end of the stomach. The fundus is completely invested by peritoneum; it is in relation, in front, with the abdominal parietes, immediately below the ninth costal cartilage; behind with the transverse colon. The neck is narrow, and curves upon itself like the letter S; at its point of connection with the cystic duct it presents a well marked constriction.
The gall bladder consists of three coats: serous, fibromuscular, and mucous. The external or serous coat is derived from the peritoneum; it completely invests the fundus, but covers the body and neck only on their under surfaces. The fibromuscular coat, a thin but strong layer forming the frame work of the sac, consist of dense fibrous tissue, which interlaces in all directions, and is mixed with plain muscular fibers, disposed chiefly in a longitudinal direction, a few running transversely. The internal or mucous coat is loosely connected with the fibrous layer. It is generally of a yellowish-brown color, and is elevated into minute rugae. Opposite the neck of the gall bladder the mucous membrane projects inward in the form of oblique rides or folds, forming a sort of spiral valve. The mucous membrane is continuous through the hepatic duct with the mucous membrane lining the ducts of the liver, and through the common bile duct with the mucous membrane of the duodenum. It is covered with columnar epithelium.
To get blood to the gallbladder starting in the celiac trunk the blood would travel next throught the common hepatic artery, next it would go through the proper hepatic artery, then the right branch and finally to the cystic artery.
Innervation to the gallbladder is supplied by the hepatic plexus which receives branches from the sympathetic trunk via the greater and lesser splanchnic nerves, and also from the vagus nerve via the hepatic branches.
Vesica biliaris (Fellea)