What are the causes of gallbladder (biliary) distension?

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From the Guidelines

Gallbladder distention is most commonly caused by obstruction of the cystic duct or common bile duct, typically by gallstones, which prevents bile from flowing out of the gallbladder, as supported by recent studies 1.

Causes of Gallbladder Distention

The causes of gallbladder distention can be broadly categorized into obstructive and non-obstructive causes. Obstructive causes include:

  • Gallstones (cholelithiasis) blocking the cystic duct or common bile duct
  • Tumors of the gallbladder, bile ducts, or pancreas
  • Functional disorders like biliary dyskinesia Non-obstructive causes include:
  • Systemic conditions such as diabetes, certain medications, and prolonged fasting affecting gallbladder motility
  • Infections of the gallbladder (acute cholecystitis)
  • Parasitic infections like ascariasis physically blocking bile ducts
  • Increased back pressure in the biliary system due to conditions like pancreatitis or sphincter of Oddi dysfunction

Clinical Presentation and Diagnosis

Patients with gallbladder distention typically experience right upper quadrant pain, nausea, vomiting, and sometimes fever. Diagnosis involves a detailed history, targeted physical examination, and pertinent laboratory studies, including hepatic profile and imaging studies like abdominal ultrasound, CT, or MRCP 1.

Treatment

Treatment depends on the underlying cause but often includes pain management, antibiotics for infection, and potentially surgical removal of the gallbladder (cholecystectomy) for severe or recurrent cases. It is essential to identify the cause of gallbladder distention to provide appropriate treatment and prevent complications. According to the most recent study 1, the most common causes of jaundice, which can be related to gallbladder distention, are hepatitis, alcoholic liver disease, blockage of the common bile duct by a gallstone or tumor, and toxic reaction to a drug or medicinal herb.

From the Research

Causes of Gallbladder Distention

The causes of gallbladder distention can be attributed to various factors, including:

  • Gallstones, which can block the cystic duct and prevent the gallbladder from emptying properly 2, 3, 4
  • Inflammation of the gallbladder, such as acute or chronic cholecystitis, which can cause the gallbladder to become distended 2, 3
  • Choledocholithiasis, which is the presence of stones in the common bile duct, and can cause obstruction of the bile duct and subsequent distention of the gallbladder 3, 4
  • Biliary dyskinesia, which is a motility disorder of the gallbladder, and can cause the gallbladder to become distended due to abnormal contractions 3
  • Other conditions, such as gallbladder hydrops, which is a condition characterized by the distention of the gallbladder due to the accumulation of bile 5

Risk Factors

Certain risk factors can increase the likelihood of developing gallbladder distention, including:

  • Obesity, which can increase the risk of developing gallstones and subsequent gallbladder distention 2
  • Diabetes mellitus, which can increase the risk of developing gallstones and subsequent gallbladder distention 2
  • Estrogen and pregnancy, which can increase the risk of developing gallstones and subsequent gallbladder distention 2
  • Hemolytic diseases, which can increase the risk of developing gallstones and subsequent gallbladder distention 2
  • Cirrhosis, which can increase the risk of developing gallstones and subsequent gallbladder distention 2

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Cholelithiasis and cholecystitis.

Journal of long-term effects of medical implants, 2005

Research

Choledocholithiasis: evolving standards for diagnosis and management.

World journal of gastroenterology, 2006

Research

Gallbladder Disorders: A Comprehensive Review.

Disease-a-month : DM, 2021

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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