Front view of the gallbladder
The gallbladder is a small pouch that sits just under the liver. The gallbladder stores bile produced by the liver. After meals, the gallbladder is empty and flat, like a deflated balloon. Before a meal, the gallbladder may be full of bile and about the size of a small pear.
In response to signals, the gallbladder squeezes stored bile into the small intestine through a series of tubes called ducts. Bile helps digest fats, but the gallbladder itself is not essential. Removing the gallbladder in an otherwise healthy individual typically causes no observable problems with health or digestion, yet there may be a small risk of diarrhoea and fat malabsorption.
Gallstones (cholelithiasis): For unclear reasons, substances in bile can crystallise in the gallbladder, forming gallstones. Common and usually harmless, gallstones can sometimes cause pain, nausea or inflammation.
Cholecystitis: Inflammation of the gallbladder, often due to a gallstone in the gallbladder. Cholecystitis causes severe pain and fever, and can require surgery when inflammation continues or recurs.
Gallbladder cancer: Although rare, cancer can affect the gallbladder. It is difficult to diagnose and usually found at late stages when symptoms appear. Symptoms may resemble those of gallstones.
Gallstone pancreatitis: An impacted gallstone blocks the ducts that drain the pancreas. Inflammation of the pancreas results in a serious condition.
Abdominal ultrasound: A non-invasive test in which a probe on the skin bounces high-frequency sound waves off structures in the abdomen. Ultrasound is an excellent test for gallstones and to check the gallbladder wall.
HIDA scan (cholescintigraphy): In this nuclear medicine test, radioactive dye is injected intravenously and is secreted into the bile. Cholecystitis is likely if the scan shows bile doesn’t make it from the liver into the gallbladder.
Cholangiography: This procedure involves injecting dye into your bloodstream, which will concentrate in your gallbladder and bile ducts and show up on an X-ray.
Endoscopic retrograde cholangiopancreatography (ERCP): This procedure also uses dye injected into the bile system ducts, but the doctor uses a flexible tube inserted through the mouth, through the stomach, and into the small intestine. The doctor can see through the tube and inject dye into the bile system ducts. Tiny surgical tools can be used to treat some gallstone conditions during ERCP.
Magnetic resonance cholangiopancreatography ( MRCP): An MRI scanner provides high-resolution images of the bile ducts, pancreas and gallbladder. MRCP images help guide further tests and treatments.
Endoscopic ultrasound: A tiny ultrasound probe on the end of a flexible tube is inserted through the mouth to the intestines. Endoscopic ultrasound can help detect choledocholithiasis and gallstone pancreatitis.
Abdominal X-ray: Although they may be used to look for other problems in the abdomen, X-rays generally cannot diagnose gallbladder disease. However, X-rays may be able to detect gallstones.