I hope this question doesn’t fall under “asking for medical advice”, if it does, I apologize.
Brief backgroud: In early November of '06, my mother had femoral bypass surgery in her legs. The surgery went fine and she spent the next 9 days in the hospital. However, the day before she was to be released, for some reason, she vomited and aspirated it, causing cardiac arrest. It is estimated she was in that condition for about 15-20 minutes before this was noticed by staff and CPR was administered (there are some differing accounts on this point, but that’s a different story.) They were able to keep her alive through artificial means until the next day when we had them removed (she showed no brain activity and Mom and us kids had talked about this on an earlier date - which I HIGHLY recommend you do with your family, btw).
Well, we finally got the coroner’s report this week. In it, it states that her gallbladder was “distended with bile”. Now, when Mom was on the respirator, they had to continually pump her stomach because she was producing a prodigious amount of dark green liquid, which I presume is bile. And they didn’t know why. But I suspect that is what my mom choked on.
So here are my questions: What would cause the gallbladder to act in this fashion? Also, can anybody tell me if I could hire someone to translate the coroner’s report into layman’s terms?
I want this so badly to be God’s will and nobody could have prevented her death, but we have reason to believe she was vomiting for several days. Any help is appreciated.
Just as a starting point here, I’ll mention that in cats (and to a lesser degree dogs) the gall bladder will distend with bile during periods of inappetence (not eating). The gall bladder is normally where bile is stored by the body. A cat that does not eat for 24 to 48 hours will have a gall bladder that is pretty full.
As far as “translation” of medical jargon, do you have a medical school in your area?
There are some medications that can reduce nausea but IIRC stopping your body from vomiting if it really wants to is tricky if not impossible. You can run various types of drains and or suction via nasogastric tubes to help avoid any detrimental fluid buildup but this may or may not have been part of her care plan.
15-20 min would not be an unreasonable amount of time for patients in a med/surg unit with no particular monitoring to go unsupervised, many can easily go hours especially if other little disasters befall that particular unit.
You will need one of the board MD’s for hyperactive gall bladder issues…not my baliwick, I was just an EMT.
Next question, what was your mothers diet on that day. If she was due to be released she would probably be on a normal or adjusted for other conditions but otherwise normal foods. IF she was on a normal diet and got queasy, vomited, and aspirated it, theres not a whole lot of way to prevent it. The legal Q IMHO would be if she was on normal diet was that appropriate for her current condition, if so, just kinda one of those unfortunate things, it just so happened to occur while she was still in the hospital.
Going only by what you’ve presented so far, I’d say that the gallbladder distention is more a symptom of her being on the ventilator with nothing by mouth for a day (or longer, if she was nauseated and not eating much beforehand). To expand on what vetbridge said, the liver continually makes bile and the gallbladder collects it, then dumps its load of bile into the intestine after a meal. If there is no meal stimulus, the gallbladder doesn’t empty; but it can only hold a given amount of bile. Once the gallbladder is full, newly secreted bile just leaks into the gut (provided that the sphincter of Oddi is not blocked). The ‘distended with bile’ comment likely just means that the gallbladder was full to capacity, with overflow going to the intestine.
In a healthy person, bile does not make its way into the stomach - it is released into the small intestine a short way downstream of the stomach, below the sphincter muscles at the stomach’s end, and is kept downstream by the peristaltic motion of the gut. The reflux of bile into the stomach in significant amounts is abnormal, but nonspecific. If the gastric suction tube is advanced too far and enters the small intestine, of course, it will also bring up bile (this is not uncommon). Many surgical patients are struck by ileus, which is the disruption of normal intestinal peristalsis such that food and secretions pool in the stomach/intestine. This can lead to nausea and vomiting. Although it usually affects patients who have undergone abdominal surgery, any sufficiently ill person can be afflicted; especially those whose mobility has been compromised. It is likely that your mother had some degree of ileus after her cardiac arrest, which could be the cause of the reflux of bile into her stomach.
Long story short: the gallbladder distention by itself does not imply a diseased or malfunctioning gallbladder.
Thanks to those who have replied. I’ll just add a little more info.
Unfortunately, it was occurring several days prior to the cardiac arrest. Approximately four days earlier while one of my sisters was visiting her, my mom vomitted while sitting in the bed. My sister said it looked exactly like what was being pumped from my mom’s stomach. At the time, my sister notified the nurse and cleaned her up, but for some reason there is no record of this ever occurring. The nurse never wrote it down.
While recuperating, my mom also suffered from an impacted bowel. After some treatments, she said she was having some normal BMs, but we don’t know for sure. She was eating light meals and she was able to use the restroom unaccompanied. I should have mentioned earlier that for some reason my mom wasn’t thinking clearly. My point is this: I am beginning to think that my mom just told the doctor’s and nurses that she was having normal BMs because she was sick and tired of the various treatments and wanted to get the hell out of the hospital. But if she was still vomiting, shouldn’t there be some sort of record of it even if she could make it to the restroom (she couldn’t move quickly and surely would’ve had accidents)? I guess I thought that perhaps the gall bladder was acting as it was due to a possible bowel impaction.