Differential Peritoneal Reflection of Gall Bladder: A Gross Anatomical Study

Abstract

CONTEXT: Variations in the peritoneal reflections of the gallbladder are encountered during surgery and post-mortem examinations mainly form of mesentery and often have significant clinical implications, which can be life threatening at times. AIM: In this study, the manner of the peritoneal reflection over the gall bladder, its relative adherence to the gall bladder fossa and the relation of the fundus to the inferior margin of liver was examined. SETTINGS AND DESIGN: This cadaveric gross anatomical study was undertaken in the Department of Anatomy, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India and Subharti Medical College, Meerut, Uttar Pradesh, India, in the course a four year period i.e. 2008 to 2012, after obtaining necessary permission from the Institutional Ethical Committees. METHODS AND MATERIAL: It was carried out on one hundred gall bladders specimens, obtained from 10% formalin fixed cadavers during routine undergraduate students dissection The liver along with the gall bladder was retrieved from the abdominal cavity during undergraduate dissection of the abdomen and the peritoneal reflection over it was studied. RESULTS: Differential peritoneal reflections were observed in seven out of hundred specimens and formation of mesentery over the whole organ was found in two. In two there was mesentery over the neck and upper part of body. One the gall bladder was found floating in the gall bladder fossa but without the formation of mesentery. CONCLUSIONS: Differential peritoneal reflections of gall bladder were seen in seven specimens and mesentery formation to various degrees was seen in four. It was observed that peritoneal attachment of the gall bladder and the relative adherences of the viscus to the gall bladder fossa were closely associated.