Biliary sludge
| Biliary sludge | |
|---|---|
| Other names | Gallbladder sludge, Microcrystalline disease, Biliary sediment, Thick bile, Biliary sand, biliary gravel |
 | |
| Abdominal ultrasonographyshowing biliary sludge and gallstones | |
| Specialty | Gastroenterology |
Biliary sludgerefers to a viscous mixture of small particles derived frombile.[1][2]These sediments consist ofcholesterolcrystals,calciumsalts, calciumbilirubinate,mucin,and other materials.[1][2][3]
Signs and symptoms
[edit]Complications
[edit]Biliary sludge may cause complications such asbiliary colic,acute cholecystitis,acute cholangitis,andacute pancreatitis.[1][2]
Cause
[edit]Biliary sludge has been associated withpregnancy,rapid weight loss,total parenteral nutrition,drugs such asceftriaxoneandoctreotide,solidorgan transplantation,and gastric surgery.[1][2]In many of these conditions, it is thought that the impairment in the contractility of the gallbladder leads to the formation of the sludge.[2]
Pathophysiology
[edit]The pathophysiology of biliary sludge formation is likely related togallbladderdysmotility.[2]It is presumed that because the gallbladder is unable to effectively empty, the biliary sludge can start to accumulate.[2]
Diagnosis
[edit]
Biliary sludge is typically diagnosed byCT scanortransabdominal ultrasonography.[1][2]Endoscopic ultrasonographyis another moresensitiveoption. However, thegold standardis considered to be direct microscopy of aspirated gallbladder bile.[1][2]This method is much more sensitive, although it is less practical.[2]
Treatment
[edit]For patients without symptoms, no treatment is recommended. If patients become symptomatic and/or develop complications,cholecystectomyis indicated.[1]For those who are poor surgical candidates,endoscopicsphincterotomy may be performed to reduce the risk of developingpancreatitis.[1]
Prognosis
[edit]The clinical course of biliary sludge can do one of three things: (1) it can resolve completely, (2) wax and wane, or (3) progress togallstones.[1][2][3]If the biliary sludge has a cause (e.g. pregnancy), it oftentimes is resolved when the underlying cause is removed.[3]
Epidemiology
[edit]The prevalence of biliary sludge is low in the general population.[2]It has been reported that the prevalence ranges from 0-0.20% in men and 0.18-0.27% in women.[2]However, in patients with certain conditions, the prevalence may be higher.[2]
See also
[edit]References
[edit]- ^abcdefghiShaffer, E. A. (2001). "Gallbladder sludge: What is its clinical significance?".Current Gastroenterology Reports.3(2): 166–73.doi:10.1007/s11894-001-0015-6.PMID11276386.S2CID46592201.
- ^abcdefghijklmnPazzi, P; Gamberini, S; Buldrini, P; Gullini, S (2003). "Biliary sludge: The sluggish gallbladder".Digestive and Liver Disease.35 Suppl 3: S39-45.doi:10.1016/s1590-8658(03)00093-8.PMID12974509.
- ^abc"Gallbladder and Bile Duct Disorders".Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.Retrieved15 January2015.
External links
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