Biliary Sludge

  1. Cynthia W. Ko, MD;
  2. John H. Sekijima, MD; and
  3. Sum P. Lee, MD, PhD
  1. From the University of Washington and Veterans Affairs Puget Sound Health Care System, Seattle, Washington.
    1. Figure 1. Biliary sludge appears as low-amplitude echoes without postacoustic shadowing. The echoes layer in the dependent portion of the gallbladder and shift slowly with positioning. (Courtesy of Dr. Tom Winter, University of Washington, Seattle, Washington.).
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      Figure 1. Biliary sludge appears as low-amplitude echoes without postacoustic shadowing. The echoes layer in the dependent portion of the gallbladder and shift slowly with positioning. (Courtesy of Dr. Tom Winter, University of Washington, Seattle, Washington.). Biliary sludge on ultrasonography. Top.Bottom.
    2. Figure 2. Cholesterol monohydrate crystals appear as rhomboid plates. Pigment granules appear as reddish-brown, amorphous clumps.
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      Figure 2. Cholesterol monohydrate crystals appear as rhomboid plates. Pigment granules appear as reddish-brown, amorphous clumps. Biliary sludge on microscopy. Left.Right.
    3. Figure 3. ERCP = endoscopic retrograde cholangiopancreatography.
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      Figure 3. ERCP = endoscopic retrograde cholangiopancreatography. Suggested algorithm for diagnosis in patients with recurrent episodes of acute pancreatitis in whom biliary sludge is suspected.
    4. Figure 4. UDCA = ursodeoxycholic acid.
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      Figure 4. UDCA = ursodeoxycholic acid. Suggested algorithm for treatment in patients with a diagnosis of biliary sludge.
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    This Article

    1. Ann Intern Med February 16, 1999 vol. 130 no. 4 Part 1 301-311
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