Expansion
Fundus, body, infundibulum and neck
Expansion
- Fundus - the rounded blind end, projecting beyond the liver edge; the only part covered entirely by peritoneum
- Body - lies in the gallbladder fossa against the liver
- Infundibulum - the tapering part; Hartmann’s pouch is a dilatation here
- Neck - narrows into the cystic duct, which carries the spiral valves of Heister
The gallbladder holds about 50 ml and concentrates bile up to tenfold.
Hartmann’s pouch is where stones typically impact. When a large stone there compresses the adjacent common hepatic duct, it produces Mirizzi syndrome, obstructive jaundice from external compression rather than a duct stone, and a well-recognised trap at cholecystectomy because of the risk of bile duct injury.
Chronic impaction can also erode into the duct or the duodenum, creating a cholecystoenteric fistula.