Other

Obstruction of the bile ducts. Symptoms and treatment of blocked bile ducts

The main symptoms of blockage of the gallbladder duct should be known in order to recognize it in time.
at dangerous pathology. Blockage of the bile duct is a blockage of the channel that comes from the organ by a stone that comes out of it along with the flow of bile. It is worth considering a description of the signs and methods of treatment of this pathology.

Bile is a yellow-green substance that is produced in the liver and is stored in gallbladder. From there it penetrates through the pancreas into small intestine. The main task of this liquid is to digest lipid structures that come with foods. After eating food, this substance comes from the gall bladder, which begins digestion and cleansing the liver of toxins and breakdown products.

Why does the gallbladder duct become blocked?

Blockage of the gallbladder duct occurs due to various reasons, which have a direct connection with the organ and its pathways, liver, small intestine:

the presence of stones in the gall bladder;
inflammation in the ducts;
neoplasms;
scarring of tissue and narrowing of the lumen;
injuries;
pancreatitis;
increase in size lymph nodes in the liver;
the appearance of strictures;
neoplasms in the pancreas or other organs of the gastrointestinal tract;
hepatitis;
helminthic infestation;
cirrhosis.

These provoking factors can cause blockage of the bile duct with all the ensuing symptoms;

The first symptoms of a blocked gallbladder duct

Symptoms of blockage of the gallbladder duct are characterized by increasing character. But in some cases, symptoms may occur over a short period of time and increase rapidly. In many cases, blockage symptoms appear after the bile ducts become affected. infectious process. A person rarely immediately pays attention to the symptoms of the first stage of the disease, starting treatment only when the blockage has reached a serious stage.

Often a person consults a doctor when symptoms such as blockage of the bile duct appear, elevated temperature bodies and severe pain. At this stage of the disease, symptoms are accompanied by sudden weight loss, as well as severe paroxysmal pain in the lower abdomen on the right. The skin becomes yellow, a person pays attention to what is happening to him. severe itching skin systematic or periodic. This signals that the gall blockage has developed into a serious stage.

It should also be noted that if there is a lack of bile acids may occur in the intestines further consequences such a state:

Lack of color in stool.
Bilirubin begins to be actively excreted by the kidneys, so the urine becomes intensely dark in color.
If the canals are partially blocked, there is high probability periodic alternation of discolored feces with a substance of a specific shade.
On initial stage Blockage of the bile ducts often causes symptoms that resemble jaundice. Among them is a yellowish tint of the epidermis and the whites of the eyes.
All mucous membranes on the human body can acquire a yellowish tint.
At a serious stage of development pathological process Symptoms such as tremors of the limbs and intense sweating often occur.

If a person with such a diagnosis is not provided with timely medical assistance, the doctor's prognosis is not very favorable. Therefore, it is important to know the risk factors that increase the likelihood of developing this pathological condition:

Pain in the right hypochondrium. Etiology pain can be different, the pain can be sharp or paroxysmal, stabbing or weakly pulling.
Urine is dark in color, this sign should cause concern immediately after its appearance.
Hyperthermia, tremor of the upper and lower limbs, intense sweating.
Itching of the epidermis.
Signs of jaundice are yellowness of the skin, sclera of the eyes, yellowness of the mucous membranes.
Regular nausea, periodic vomiting with bile, which does not bring the desired relief.
Discoloration of stool, in which undigested lipid structures are clearly visible, this sign indicates a deficiency of secreted bile.

Therapeutic measures

The key goal of treating a blockage is to free the bile duct from the obstruction or to significantly improve the patient’s well-being. Stones stuck in the gallbladder are often removed through the use of an endoscope during diagnostic measure, which includes examination of organs abdominal cavity.

Sometimes treatment of the disease is carried out exclusively surgically to remove the obstruction that is blocking the ducts. If the obstruction is caused by a stone, the gallbladder is surgically removed. After the operation, the patient will need to undergo a course antibacterial agents, which the doctor selects individually for each patient. Antibiotics are prescribed if the doctor suspects an infectious process.

Most common methods obstruction therapy:

Complete removal of the gallbladder through surgery.
Treatment with an endoscope is used to remove small stones or to install a stent, which will subsequently expand the ducts.
Sphincterotomy is used by the doctor if stones are found in multiple quantities both in the bile ducts and in the organ itself.

It is very important to know what to do when the bile ducts are clogged, the symptoms and treatment of which disease should be considered and what the consequences are this state possible. What is a blocked duct? This is the name for obstruction in the form of a mechanical obstacle that bile encounters during its movement, leaving the liver or gall bladder towards the duodenum.

Symptoms of the disease

According to medical statistics, about 20% of the people studied experience this phenomenon. And most of them are women.

May occur as a consequence of the following diseases:

cholelithiasis;
various tumors or inflammations associated with the liver or gall bladder;
strictures and scars in the common duct.

The main symptoms indicating that there is a problem with the ducts include:

the occurrence of pain in the hypochondrium on the right;
manifestation of symptoms of jaundice;
acholic feces are observed along with dark urine;
The level of bilirubin in the blood increases.

The diagnosis should only be made by a doctor based on the studies performed. biochemical analysis blood. In addition, RCCP, ultrasound, MRI and CT of the abdominal organs are required. If a problem is identified, surgical treatment should be performed.

Depending on the severity of the disease, it is possible to carry out endoscopic or laparoscopic treatment. In more advanced or severe cases, the question of performing an extended operation to remove the blockage is raised.

As a result of difficulties in the movement of bile, a disease called subhepatic jaundice may occur. Quite often, conduction problems can occur after attacks of colic, as well as when symptoms associated with the development of inflammation appear. IN in this case will need to be provided as soon as possible medical care a patient suffering from blocked bile ducts.

Cholangitis symptoms and treatment

The main causes of the disease

Caused by obstruction of the biliary tract, the problem is not only the formation of internal blockage, but also as a consequence of external compression. Doctors identify a complete or partial mechanical obstruction to the outflow of bile. Moreover, its degree will depend on what clinical manifestations are currently being observed.

It is already known that there is a whole series diseases that can lead to obstruction of patency, resulting in intrahepatic pain as a consequence of the absence or incomplete flow bile from the liver to the duodenum.

Blockage of passages may occur when the patient is diagnosed with:

Symptoms of the development of a disease associated with blockage of the bile ducts are a multicomponent process. Most often, it shows that an inflammatory process has appeared and is beginning to develop in the bile ducts. Moreover, the inflammation itself contributes to a significant thickening of the mucosa, which inevitably leads to a decrease in the lumen in the ducts themselves.

Naturally, a stone that gets into the passage simply gets stuck in it and cannot be washed out with bile. As a result, the common passage is blocked completely or partially. Bile begins to accumulate, widening the passages. As a result, when bile leaves the liver, it enters the gallbladder, stretching it. Because of this, symptoms worsen and cholecystitis develops.

A diagram of such a situation is possible provided that the stones arise in the gallbladder. During their life, they can get into the duct, blocking it completely or partially. As a consequence of this process, empyema or dropsy will develop. If secretion of whitish mucus from the common bile duct mucosa is detected, this may indicate not only blockage, but also the beginning irreversible changes in the bile ducts themselves, which will inevitably affect health.

As a result of obstruction of bile along its ducts, destruction of hepatocytes begins to develop. As a result, acids and the accompanying bilirubin can enter the blood, and its infection begins. And they are astonished as they themselves blood vessels, and organ tissues.

Lack of bile in the body also negatively affects the functioning of the body. After all, it participates in the digestion process, breaking down fats and vitamins, accelerating their absorption. As a result, a person experiences hypoprothrombinemia, which is a disease associated with blood clotting, hypovitaminosis.

If bile stagnation occurs, a significant disruption of the liver parenchyma may occur, which means that the person faces liver failure.

How to check your gallbladder

Etiological factors

The main risk factors for the occurrence and subsequent development of blockage in the bile ducts include obesity. This process can also be triggered by rapid or sudden weight loss, as well as:

injuries received in the area of the right half of the abdominal cavity;
operations performed in the near past on the biliary tract, liver or gall bladder;
penetration of infections associated with the hepatobiliary system, pancreas, developing due to weakened immunity;
during the current chronic stage pancreatitis;
if there are stone formations in the gallbladder;
with advanced pancreatic cancer.

It is for this reason that doctors will need to know exactly all the symptoms of the disease and carry out full study. This is necessary to identify the cause and prescribe precise treatment, including emergency surgical intervention.

Therapy methods

If during the study a blockage of the bile ducts was identified, then additional consultation with a gastroenterologist or surgeon may be required. Only this makes it possible not only to determine the severity of the disease, but also to prescribe treatment. Moreover, if a severe form of the disease is detected, the patient should be transferred to the department for treatment. intensive care, carry out antibacterial, infusion and detoxification forms of therapy. This is due to the fact that before surgical treatment, it is necessary to stabilize the patient’s condition in order to avoid the risk of complications or even death.

In order to facilitate the outflow of bile, it is necessary to use various non-invasive techniques. This may be extraction of bile duct stones or nasobiliary drainage using a special probe, cholecystostomy and choledochostomy.

If the patient is in satisfactory condition, or relief has occurred, then endoscopic treatment methods are used for treatment. In this case, during endoscopy they will dilate all clogged ducts, which is the introduction of a special plastic or mesh tube into the bile ducts. Thanks to it, it is possible to guarantee that sufficient clearance width is maintained. This procedure called endoscopic common bile duct stenting. In some cases, endoscopic balloon dilatation of the so-called sphincter of Oddi is necessary.

Biliary obstruction is a blockage of the bile ducts that carry bile from the liver to the gallbladder and small intestine.

Reasons

It is a fluid formed in the liver. It contains cholesterol, bile salts and metabolic products such as bilirubin. Bile salts help the body break down fats. From the liver, bile flows through the bile ducts into the gallbladder, where it accumulates. After eating, bile enters the small intestine.

When the bile ducts are blocked, bile accumulates in the liver, and due to an increase in the level of bilirubin in the blood, jaundice (yellow coloration of the skin) develops.

Risk factors for the disease include:

Presence in medical history gallstones, chronic pancreatitis or pancreatic cancer
Abdominal injuries
Recent surgery on the biliary tract
History of biliary system cancer (eg, bile duct cancer)

In persons with weakened immune system obstruction can also be caused by infection.

Symptoms

Pain in the upper right corner of the abdomen
Darkening of urine
(jaundiced discoloration of the skin)
Nausea and vomiting
Stool discoloration

Diagnostics

The doctor or nurse will examine you and your stomach.

The following blood test results may indicate possible obstruction:

Increased bilirubin levels
Increased alkaline phosphatase levels
Increased liver enzyme levels

The following tests may be ordered to identify possible bile duct obstruction:

Ultrasound of the abdominal organs
abdominal organs
Endoscopic retrograde cholangiopancreatography (ERCP)
Percutaneous transhepatic cholangiography (PTCH)
Magnetic resonance cholangiopancreatography (MRCP)

Bile duct obstruction may also affect the following tests:

Amylase content in blood
Radionuclide scan of the gallbladder
Blood lipase content
Prothrombin time (PT)
Bilirubin content in urine

Treatment

The goal of treatment is to relieve the obstruction. Stones can be removed through an endoscope during ERCP.

In some cases, surgery may be necessary to relieve the obstruction. If the blockage is caused by gallstones, they are usually removed. If you suspect an infection, your doctor may prescribe antibiotics.

If the obstruction is caused by cancer, the duct may be dilated. This procedure is called endoscopic or percutaneous (done through the skin near the liver) dilatation. A special tube may be placed in the duct to provide drainage.

Forecast

If the obstruction is not corrected, it can lead to life-threatening infections and a dangerous buildup of bilirubin.

Long-term obstruction can lead to chronic disease liver. Most obstructions can be relieved by endoscopy or surgical intervention. Blockages caused by cancer tend to have a worse prognosis.

Possible complications

If left untreated, complications such as infections, sepsis and liver diseases such as biliary cirrhosis can occur.

When to see a doctor

Contact your doctor if you notice changes in the color of your urine or stool, or if you have jaundice.

Prevention

Be aware of your risk factors to help you pass timely diagnosis and treatment if the bile duct is blocked. There are no methods to prevent biliary obstruction.

Bile ducts are a collection of tubular channels through which bile drains from the liver and gallbladder. The pressure generated in the liver, contraction of the sphincters, and the activity of the duct walls contribute to the movement of bile. Every day, about 1 liter of yellow-green liquid enters the intestines through the bile network.

Bile ducts and their structure

The anatomy of the bile excretory system is represented by two types of ducts - intrahepatic and hepatic:

Intrahepatic. From the name it becomes clear that the ducts are located inside the tissue of the organ, arranged in neat rows of small ducts. It is into them that the finished bile fluid enters from the liver cells. Liver cells secrete bile, which penetrates into the space of the small bile ducts, and through the interlobular canaliculi enters the large canals.
Hepatic. Uniting with each other, the tubules form the right and left ducts, which drain bile from the right and left parts of the liver. At the transverse “crossbar” of the liver, the ducts unite and form a common duct.

The extrahepatic biliary system is built on the following ducts:

Cystic - is the link between the liver and gall bladder.
Common bile duct. It originates from the junction of the hepatic and cystic intestines and flows into the duodenum. Some part of the secretion goes directly to the common bile duct, without entering the gallbladder.

The common bile duct has a complex system of valves consisting of muscle tissue. The sphincter of Lutkins ensures the passage of secretions through the cystic canal and the neck of the bladder, the sphincter of Mirizzi connects the cystic and common bile ducts. The valve of Oddi is located in the lower reaches of the common duct. When at rest, the valve is closed, allowing fluid to collect and concentrate in the gall bladder. At this time, the color of the bile changes to dark olive, the amount of enzymes increases several times. During the digestion of food, it is formed active substance, due to which the valve opens, the gall bladder contracts and fluid is released into the digestive system.

Bile duct diseases

Blockage of ducts with stones.

Correct composition bile, healthy ways of its removal are necessary for proper operation body. Experts have diagnosed many diseases of the biliary tract, let’s consider the most common ones:

Blocked ducts

A mechanical obstacle may form in the path of bile movement. The result is that the channels are clogged and the free passage of bile is impaired. Blocked ducts – dangerous aggravation underlying disease that is responsible for the development obstructive jaundice. Patency disorder is divided into complete and partial. It depends on how clogged the ducts are clinical picture, the brightness of the manifestation of signs. One of common reasons the occurrence of interference with the passage of secretions is cholelithiasis.

Cholelithiasis is a gallstone disease. It is characterized by the formation of concretions (stones) not only in the ducts, but also in the bladder. The culprit for the formation of stones is stagnation in the produced fluid, a change in metabolism. The connection of stones is different. The composition includes yellow blood pigment (bilirubin), acids, and natural fatty alcohol (cholesterol).

There are cases when stones remain in a person’s body for years, and he does not suspect anything. It is worse when the duct is blocked by a stone, since similar situation causes troubles (inflammation, colic). With the onset of the inflammatory process, pain occurs, which is concentrated in the area of the right hypochondrium and can radiate to the back. Fever and vomiting often accompany the inflammatory process. Help provided at the wrong time leads to development liver failure which could result in death.

The onset and development of complications occurs in several stages. Inflammatory process ducts serves as a trigger for the onset of complications. It promotes thickening of the walls, as a result, a decrease in the lumen. During this period, there is not enough space for the stone passing through the duct; a blockage forms, blocking the path of bile. The fluid accumulates, stretching the walls of the organ, or can immediately go into the bladder, stretching the organ, causing an exacerbation.

Narrowing of the ducts

Internal narrowing can form anywhere in the common, lobar, or hepatic canals. Its appearance indicates the cause of the problem. IN surgical treatment narrowing the diameter of channels is one of the most relevant and complex issues. Based on the research results, three forms of stricture are distinguished:

When strictures appear, the areas above the narrowed parts of the vessels are expanded. In places where circulation is difficult, bile stagnates and thickens, creating a favorable climate for the formation of stones. Signs of a problem will be: