Section IV. DISEASES/DISORDERS OF THE ACCESSORY ORGANS
3-20. THE ACCESSORY ORGANS
Accessory organs of the gastrointestinal system include the liver and gallbladder.
The liver is the largest glandular organ in the body and is involved in vital, complex
metabolic activities. Liver functions include the formation and excretion of bile;
utilization, transformation, and distribution of vitamins, proteins, fats, and carbohydrates;
detoxification of chemicals (including drugs), bacteria, and foreign elements that may be
harmful, and the formation of antibodies and immunizing substances, including gamma
globulin. Cirrhosis of the liver is a disease which can drastically interrupt or stop these
important liver functions. The gallbladder receives bile made by the liver, changes the
bile by absorbing water and minerals so that the bile is more concentrated, and releases
the bile when it is needed. Problems involving gallbladder can result in acute
cholecystitis and/or cholelithiasis.
3-21. LIVER DISORDERS
a. Cirrhosis of the Liver.
(1) Definition. Cirrhosis is a chronic disease of the liver in which the liver is
first damaged and then an excess of fibrous tissue develops. As the liver tries to repair
the damage, scarring develops, and eventually blood cannot flow through its normal
channels in the liver. Liver cells cannot regenerate.
(2) Etiology. A variety of agents may damage the liver cells and the liver's
connective tissue. Chronic gastroenteritis (chronic inflammation of the gastrointestinal
tract) may impair liver function. Streptococcus infections and Schistosoma (blood flukes
which are parasites in man and animals) may lead to liver cirrhosis. Chemicals
including alcohol as well as carbon tetrachloride, arsenic, and lead can lead to cirrhosis.
Obstruction of the biliary ducts when complicated by inflammation is a frequent cause of
cirrhosis. The result is that necrotic liver cells are damaged. Liver cells cannot grow
new cells to replace damaged ones. Instead, connective tissue replaces the cells with
tissue containing fibers.
(3) Signs and symptoms. General signs of liver damage occur. Early signs
include gastrointestinal disturbances, indigestion (dyspepsia), change in bowel habits,
and chronic gastritis (chronic inflammation of the stomach). Later in the disease, these
signs and symptoms occur: fever, liver enlargement, gradual weight loss, and
accumulation of fluid in the peritoneal cavity (ascites).