Pathologic anatomy

The intensity of the inflammatory process in the gallbladder may be different: from catarrhal, the current in the surface layer of mucous, to flamanskogo, deeply penetrating into the wall of the gallbladder.
Condensed bile and microbes that stays in pseudoinertial (formed from the sinuses Rokitanskйho-Asifa)support centers constantly smoldering inflammation, which inflame of relapse. Chronic cholecystitis pathological process covers all layers of the gallbladder wall, the latter becomes dense, fibrous changed. Bladder wall gradually sklerosiruta, sometimes it can lime Deposit. In the gallbladder wall formed abscesses, ulceration. Plastic soropibinojexon inflammation of the gallbladder gradually leads to the formation of adhesions, deforming the gallbladder, fusing it with neighboring organs (pericholecystic). Fusion impair the motility of the bladder, can stenoziruty and distort the bile ducts. All this creates conditions for stable maintenance of the inflammatory process and its periodic aggravations. The presence of stones influence the development and course of cholecystitis and on relevant changes in the wall of the bladder and ducts. The so-called asymptomatic stones over time can cause sores on the mucous membrane of the bubble. And in the presence of stones catarrhal inflammation of the bladder may result in complete recovery. When there is a blockage of the cystic duct stone, develops inflammatory dropsy of the gallbladder. When this bubble tense and filled with white bile".
In introducing cholecystitis with stone bubble tight filled with pus, cystic duct tightly sealed stone or obliteriruty - empiema gallbladder.
With the development of bedsores from the pressure of the stone on the wall of the bubble (if any adhesions between the bladder and hollow body) can form links between them - internal biliary fistula.
Usually inflammation of the gallbladder is combined with inflammation of the bile ducts (cholangitis, angiocholitis). The isolated cases of cholecystitis rare. This is due to the extremely close anatomical and physiological relationship gall bladder and ducts, which is why inflammation of the gallbladder is easily applicable to the duct or simultaneously flashed on them. To indicate simultaneous inflammation of the gallbladder and ducts N. D. Strazhesko coined the term "cholecystoangiogram, and A. L. Myasnikov - "angiocholitis".
In patients with cholecystitis often arise defeat parenhima liver - mariangiola, pelangiholiday fibrosis, degenerative changes in the liver cells, sometimes progressing to biliary cirrhosis (N. N. Anichkov, M. A. Zakharyevskaya Street, 1938; Popper, Schaffner, 1957). Such conditions are indicated by the terms " hepatocholecystitis, holetsistopatii". A. Ya. the Gubergrits (1963) offers a combination of defeats the gallbladder, bile ducts and liver called holangiogepatit.
In the pancreas in severe forms of cholecystitis arise chronic swelling, focal necrosis, chronic interstitial pancreatitis with a transition to fibrosis depending on the severity of the process in the gall bladder (A. F. Kiselev, 1957).
Worth mentioning the so-called cholesterosis of a gall bladder. In this form cholecystitis in the gallbladder mucosa lack of inflammatory changes, there are clumps of cells, the cytoplasm which carries a large number of in two ways-refractive lipids. These clusters give mucous characteristic appearance, thanks to which MacGarty (1910), who described this form of cholecystitis, called it "Strawberry gallbladder" - strawberry gallbladder.