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.