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Physical and chemical properties of bile

  • Physical and chemical properties of bile

    Bile color is normal: portions A - golden yellow, amber;B - saturated yellow, dark olive, brown;C - light yellow.

    ■ Changing the color of portion A: dark yellow - when bile is thrown batch B and with hemolytic jaundice;light yellow - with lesions of the liver parenchyma, viral hepatitis, cirrhosis, obstruction of the sphincter of Odd stone, compression of the enlarged head of the pancreas, spasm of the sphincter;staining with blood - with peptic ulcer of duodenum, fetal nipple tumor, hemorrhagic diathesis;greenish color( transparent bile) - with stagnation or infection.

    n Changing the color of portion B: a weak color( white bile) - with chronic inflammatory processes with atrophy of the mucous membrane of the bladder;very dark coloration - with pathological thickening of bile in the bladder( stagnation) and with hemolytic conditions.

    ■ Color change of portion C: pale coloration - with viral hepatitis, liver cirrhosis;dark color( pleochromia) - with hemolytic jaundice;green color - with inflammatory processes of the bile ducts, cholangitis( due to oxidation of bilirubin in biliverdin), red color - from the admixture of blood in peptic ulcer of the duodenum, malignant neoplasms of the pancreas, pyloric stomach.

    Transparency. Normally, all portions of bile are transparent. A small, immediately apparent uniform turbidity is associated with an admixture of hydrochloric acid and does not indicate the presence of inflammatory changes. The turbidity of portion A is possible with increased acidity of gastric juice, pyloric insufficiency or duodenal reflux;Flakes are detected with duodenitis. The turbidity of portion B is possible with inflammatory processes in the gallbladder. Slime flakes fall in portion C in inflammatory processes of intrahepatic strokes, cholecystocholangitis.

    Reaction. Normally, Serving A has a neutral or basic reaction;portions B and C are basic. Acid reaction of portion A is possible with an inflammatory process in the duodenum. Acid reaction of portion B is characteristic for inflammation of the gallbladder, and other portions for inflammatory processes in the corresponding sections of the bile ducts.

    Density. Normally, the relative density of portion A is 1.003-1.016;B - 1.016-1.032;C - 1.007-1.011.

    ■ The relative density of portion A increases when the dose B is dropped, when hemolytic jaundice, decreases when the liver function is impaired, the liver parenchyma is affected( viral hepatitis, cirrhosis), bile infestation in the duodenum.

    ■ The relative density of portion B increases with congestion of bile( stasis), cholelithiasis, with biliary dyskinesia;It decreases with a decrease in the concentration capacity of the gallbladder.

    ■ The relative density of portion C increases with hemolytic jaundice, decreases with a decrease in bilirubin secretion( hepatitis, cirrhosis of the liver).

    Bile acids. In a healthy person, the content of bile acids in portion A is 17.4-52 mmol / l, in portion B - 57.2-184.6 mmol / l, in portion C - 13-57.2 mmol / l. An increase in the concentration of bile acids in portion C is observed with increased secretion of cholic acid by the hepatic cells, a decrease in secretory deficiency of the hepatic cells.

    HS.In a healthy person, the concentration of cholesterol in bile in portion A is 1.3-2.8 mmol / l, in portion B - 5.2-15.6 mmol / l, in C-portion 1.13.1 mmol / l. An increase in the concentration of cholesterol in portions A and B is noted in cholelithiasis, cholecystitis;Reduction - with a violation of the concentration capacity of the gallbladder.

    Bilirubin. Reference values ​​of bilirubin concentration in bile are reflected in the table.

    Table Reference values ​​of bilirubin concentration in different portions of bile

    Table Reference values ​​of bilirubin concentration in various portions of bile

    The concentration of bilirubin in bile decreases with mechanical jaundice, viral hepatitis, cirrhosis, calculous cholecystitis,increases with hemolytic jaundice, Addison-Birmer anemia, malaria.