Gallbladder adhesions are bands of internal scar tissue that adhere to the gallbladder and bind it to neighboring surfaces, such as other abdominal organs or membranes. These adhesions usually develop between adjacent serous membranes, which are delicate thin tissue sheets; the gallbladder mesentery, which connects the gallbladder to the abdominal wall, is formed out of these thin serous membranes and connective tissue layers. Adhesions developing within a connective tissue layer can be dense, and can occur as thick fibrous bands.
Adhesions can be formed due to surgery, injury, infection, or even radiation, but they most commonly develop as a result of gallbladder inflammation caused by gallstones, termed cholecystitis. Gallbladder adhesions can also develop from gallbladder cancer, associated with gallstones; however, such cancer is rare. Some have been found to be due to natural causes, such as congenital anomalies.
These adhesions can involve the cystic ducts, or gallbladder drainage vessels, as well as the liver and pancreatic ducts. They can also involve the peritoneal, or stomach, lining. Gallstone inflammation is one of the root causes of this adhesive scarring that binds tissues together because the membranes surrounding the gallbladder and helping to hold it in place are formed of many layers; connective tissue layers are arranged in a regular pattern, resembling woven wicker. If the wicker latticework is damaged, such as by inflammation, or surgery, the cells that regrow can be distorted. These distorted cells — irregularly shaped and with weaker structural patterns — form the scar tissue.
Gallbladder adhesions generally do not cause any pain or symptoms, but the conditions leading to their production, such as gallstones and inflammation, can be extremely painful. Gallstones can produce biliary colic, or pain resulting from bile duct blockage by a gallstone. This pain is localized in the upper abdomen and will generally go away in a few hours once the gallstone passes out of the duct.
Biliary colic can turn into cholecystitis, with the development of inflammation and infection, along with fever and severe abdominal pain. It occurs when an area of impaction by gallstones becomes infected. This can also occur in any blocked duct, such as the hepatic duct of the liver, or the pancreatic duct, which can cause symptoms similar to gallbladder duct blockage. The inflammation associated with cholecystitis, and the resulting damage to connective tissue, can result in the development of scan tissue and adhesions.