Gallbladder

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A Moment in History

Georg Eduard Von Rindfleisch
(1836 – 1908)

German pathologist and histologist of Bavarian nobility ancestry. Rindfleisch studied medicine in Würzburg, Berlin, and Heidelberg, earning his MD in 1859 with the thesis “De Vasorum Genesi” (on the generation of vessels) under the tutelage of Rudolf Virchow (1821 - 1902). He then continued as a assistant to Virchow in a newly founded institute in Berlin. He then moved to Breslau in 1861 as an assistant to Rudolf Heidenhain (1834–1897), becoming a professor of pathological anatomy. In 1865 he became full professor in Bonn and in 1874 in Würzburg, where a new pathological institute was built according to his design (completed in 1878), where he worked until his retirement in 1906.

He was the first to describe the inflammatory background of multiple sclerosis in 1863, when he noted that demyelinated lesions have in their center small vessels that are surrounded by a leukocyte inflammatory infiltrate.

After extensive investigations, he suspected an infectious origin of tuberculosis - even before Robert Koch's detection of the tuberculosis bacillus in 1892. Rindfleisch 's special achievement is the description of the morphologically conspicuous macrophages in typhoid inflammation. His distinction between myocardial infarction and myocarditis in 1890 is also of lasting importance.

Associated eponyms

"Rindfleisch's folds": Usually a single semilunar fold of the serous surface of the pericardium around the origin of the aorta. Also known as the plica semilunaris aortæ.

"Rindfleisch's cells": Historical (and obsolete) name for eosinophilic leukocytes.

Personal note: G. Rindfleisch’s book “Traité D' Histologie Pathologique” 2nd edition (1873) is now part of my library. This book was translated from German to French by Dr. Frédéric Gross (1844-1927) , Associate Professor of the Medicine Faculty in Nancy, France. The book is dedicated to Dr. Theodore Billroth (1829-1894), an important surgeon whose pioneering work on subtotal gastrectomies paved the way for today’s robotic bariatric surgery. Dr. Miranda.

Sources:
1. "Stedmans Medical Eponyms" Forbis, P.; Bartolucci, SL; 1998 Williams and Wilkins
2. "Rindfleisch, Georg Eduard von (bayerischer Adel?)" Deutsche Biographie
3. "The pathology of multiple sclerosis and its evolution" Lassmann H. (1999) Philos Trans R Soc Lond B Biol Sci. 354 (1390): 1635–40.
4. “Traité D' Histologie Pathologique” G.E.
Rindfleisch 2nd Ed (1873) Ballieres et Fils. Paris, Translated by F Gross

"Clinical Anatomy Associates, Inc., and the contributors of "Medical Terminology Daily" wish to thank all individuals who donate their bodies and tissues for the advancement of education and research”.

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Details: Written by: Efrain A. Miranda, Ph.D.; Published: April 23, 2015; Hits: 8301

Inferior surface of the liver

The [gallbladder] is a bile transient storage organ, part of the hepatobiliary tree, situated in the anteroinferior aspect of the liver. The gallbladder is found in a depression on the inferior aspect of the right lobe of the liver, the gallbladder fossa or fossa vesicae felleae.

In the gallbladder we describe its dome-shaped fundus, the body of the organ, and the neck which is the area that opens into the cystic duct. Close to the neck, the gallbladder has a small pouch (Hartmann's pouch) which is important for surgeons during a laparoscopic cholecystectomy, as this is where they will lock one of the instruments that allows them to manipulate the gallbladder for dissection of the organ from the gallbladder fossa (the gallbladder bed). The other surgical grasper is placed at the gallbladder fundus.

The gallbladder is composed by three layers. From deep to superficial they are:

• Mucosa: Characterized by a columnar epithelium. Towards the neck of the gallbladder the mucosa creates spiral ridges that continue in to the cystic duct.
• Fibromuscular layer: This layer is composed by connective tissue and smooth muscle, mostly longitudinal
• Serosa: This is an incomplete layer and is formed by visceral peritoneum covering the area of the gallbladder not in contact with the liver. In an unusual anatomical variation, the serosa layer can be almost complete, forming a pseudomesentery that may contains some veins.

The gallbladder receives its blood supply by way of the cystic artery, a branch of the right hepatic artery. The venous return is by way of multiple small veins that empty into the liver venous system. In some cases, these veins may form large sinuses between the liver and the gallbladder causing potential troublesome bleeding during a cholecystectomy. For those who like medical history, Dr. Eric Muhe performed the first laparoscopic cholecystectomy on September 12, 1985! We are but a few days from the 30th anniversary!

For more information on terminology on "gall-", "bile", "chol", and "chole", click here.

Sources:
1 "Tratado de Anatomia Humana" Testut et Latarjet 8 Ed. 1931 Salvat Editores, Spain
2. "Anatomy of the Human Body" Henry Gray 1918. Philadelphia: Lea & Febiger
Image modified by CAA, Inc. Original image courtesy of bartleby.com

Gallbladder

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