Applied Anatomy-(Gall bladder)

1. Gall stones block the cystic or common bile duct and cause obstructive jaundice.
   
   
2. Inflammation of the gall bladder is called cholecystits. This can be chronic or acute. Chronic cholecystitis, and especially due to stones is managed by surgical removal of gall bladder - cholecystectomy.
   
   
3. Accidental injury to gall bladder in surgery can result from failure to appreciate the variations in blood supply, and the extrahepatic duct system.
   
   
4. Carllot's triangle
   
   
   
5. Some narrow billiary channels (accessory hepatic ducts) may run from the right lobe of the liver into the anterior surface of the body of the gall bladder These may be a cause of bile leakage following cholesystectomy. Such leakage may be contained by careful coutery of the gall bladder bed. Many surgeons now patch the bed with omental material.A small pouch may exist from the right wall of the neck of the gall bladder. This is called Hartmann's pouch. And usually projects inferiorly and posteriorly towards the duodenum. Gall stones may easily lodge in this pouch.
   
   
6. Murphy's sign
   
   
7. Pain of gall bladder origin is referred to right shoulder, right side of neck and mandibular region because of phrenic nerve
   
   
8. The technique of visualizing gall bladder by introduction of radiopaque dye is called cholecystography, and the dye could be given intravenously; orally; or into the duct.

1. The spleen is not normally palpable. When enlarged, it is palpable below the left costal margin.
   
   
2. Enlargement of the spleen is called splenomegaly  and can occur due to:
   
   (+) Tropical parasitic infestations
   (+) Blood Malignancies
   (+) Glycogen or lipid storage disorders.
   
   Massively enlarged spleen can rupture spontaneously.
   
   
3. Traumatic rupture of spleen can occur in abdominal or thoracic trauma. This is common and is treated by surgical removal- Splenectomy. During this procedure the tail of the pancreas must be guarded. If the rupture is massive several pieces of splenic tissue may be seeded into the peritoneum. This is called splenosis.
   
   
4. Following splenectomy in children, a piece of splenic tissue should be buried in the peritoneum to continue function.
   
   
5. Small accessory spleens or spleniculi may be found in the neighborhood of the spleen, being especially common in the Gastrosplenic ligament and greater omentum.