Gallbladder adhesions are bands of internal scar tissue that form in the gallbladder, an internal organ in the abdominal region of humans and many animals. They basically bind the organ to other nearby surfaces like the stomach, liver, or other tissues and membranes. In most cases they are thick and dense, and often require surgery to remove. Medical professionals usually look for ways of removing them promptly because they can compromise organ functioning, but it’s rare for them to actually cause people pain. Some of the conditions that cause them can be very painful, though. Gallstones are one of the most common. Reducing and removing adhesions won’t always make conditions like gallstones less likely, but it may help.
Why They Happen
Adhesions can happen for a number of different reasons. In some cases they form after abdominal surgery, for example, particularly if the gallbladder tissues are exposed or become inflamed during healing. Injury and infection are also common causes, and radiation therapy, which can compromise the integrity of many of the body’s tissues, may also contribute.
By far the most common reason they develop is as a result of gallbladder inflammation caused by gallstones, which is known medically as cholecystitis. The membranes surrounding the gallbladder and helping to hold it in place are formed of many layers, and connective tissue layers are arranged in a regular pattern, resembling woven wicker. If the wicker latticework is damaged, the cells that regrow can be distorted. These distorted cells — irregularly shaped and with weaker structural patterns — form the scar tissue. Gallbladder adhesions can also develop from gallbladder cancer, which is frequently associated with gallstones, and in rarer cases adhesions are attributed to more or less “natural” causes, like genetic defects or family histories.
Where They Occur
The precise placement of the scar tissues usually depends on both the cause and the site of the inflammation. They 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 usually occur as thick fibrous bands. They 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.
Gallbladder adhesions generally do not cause any pain or symptoms on their own, 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.
If it isn’t treated, biliary colic can turn into cholecystitis, which is usually accompanied by 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 happen 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 often leads to adhesions.
One of the only ways to treat adhesions is to remove them surgically. Medical experts can often do this with minimal harm by using lasers and laproscopic technology, but accuracy in often depends on knowing exactly where the adhesions are in order to eliminate them in a targeted and precise way. Adhesions can usually be best identified through computed tomography (CT) scans and magnetic resonance imaging (MRI) tests. Removing them often reduces the chance of them recurring, but it doesn’t eliminate it. One of the only ways to completely prevent the possibility of gallbladder adhesions is to remove the gallbladder entirely, which is sometimes recommended for patients who seem to have chronic problems with gallstones, adhesions, or other related problems.