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Each serous membrane is composed of a secretory epithelial layer and a connective tissue layer underneath.. The epithelial layer, known as mesothelium, consists of a single layer of avascular flat nucleated cells (simple squamous epithelium) which produce the lubricating serous fluid.
The gallbladder has a capacity of about 50 millilitres (1.8 imperial fluid ounces). [2] The gallbladder is shaped like a pear, with its tip opening into the cystic duct. [4] The gallbladder is divided into three sections: the fundus, body, and neck. The fundus is the rounded base, angled so that it faces the abdominal wall.
Generally, if it is a part of the digestive tract that is free to move, it is covered by serosa, and if it is relatively rigidly fixed, it is covered by adventitia. The connective tissue of the gallbladder is covered by adventitia where the gallbladder bounds the liver, but by serosa for the rest of its surface.
The presence of large stones, >2.5 cm in diameter, within the gallbladder are thought to predispose to fistula formation by gradual erosion through the gallbladder fundus. [1] Once a fistula has formed, a stone may travel from the gallbladder into the bowel and become lodged almost anywhere along the gastrointestinal tract .
Ileus may increase adhesion formation, because intestinal segments have more prolonged contact and intestinal distention causes serosal injury and ischemia. It is usually treated with aggressive fluid support, prokinetics , and anti-inflammatories.
Jaundice is commonly caused by conditions such as pancreatic cancer, which causes blockage of the bile duct passing through the cancerous portion of the pancreas; cholangiocarcinoma, cancer of the bile ducts; blockage by a stone in patients with gallstones; and from scarring after injury to the bile duct during gallbladder removal.
The serosa/adventitia are the final layers. These are made up of loose connective tissue and coated in mucus so as to prevent any friction damage from the intestine rubbing against other tissue. The serosa is present if the tissue is within the peritoneum, and the adventitia if the tissue is retroperitoneal.
Biliary injury (bile duct injury) is the traumatic damage of the bile ducts. It is most commonly an iatrogenic complication of cholecystectomy (surgical removal of the gallbladder), but can also be caused by other operations or by major trauma. The risk of biliary injury is higher during laparoscopic cholecystectomy than during open ...