Increased incidence of biliary sludge and normal gall bladder contractility in patients with high spinal cord injury

Abstract

Background-Patients with spinal cord injury (SCI) have an increased prevalence of gallstones.Aims-To study prospectively the incidence of gallstones and gall bladder contractility in patients with SCI. Patients and methods-Thirty six consecutive patients with SCI were studied: 18 patients with SCI above thoracic 10 neuronal segment (>T10) and 18 patients with SCI below T10 (<T10). An equal number each of disease controls (multiple fractures) and healthy controls were also studied. All patients and controls underwent serial ultrasonography to detect development of gallstones and ultrasonographic measurement of gall bladder contractility. (Gut 1997; 41: 682-687) Results

Acute abdominal emergencies and spinal cord injury; our experiences: a retrospective clinical study

“…16,18 The reason for the increase in gallstone formation in this group of patients is not clear, 19 but it may be related to altered metabolic state and impaired gall bladder relaxation in an SCI patient with injury at T10 or above. 20 The studies showed normal gall bladder contraction and secretion of the cholecystokinin in SCI group, but gall bladder relaxation may impair at the T10 and higher levels. 4,20,21 One study showed that gall bladder fasting volume and ejection fraction were significantly less in SCI above T10.…”

“…20 The studies showed normal gall bladder contraction and secretion of the cholecystokinin in SCI group, but gall bladder relaxation may impair at the T10 and higher levels. 4,20,21 One study showed that gall bladder fasting volume and ejection fraction were significantly less in SCI above T10. 20 This may be about that the gall bladder is innervated from T7-T10 segments of the spinal cord.…”

“…Also in the same study, they have found increased of biliary sludge above T10 SCI patients. 20 Nino-Murcina et al 4 found that lower resting volume in SCI patients (21 ml) compared with healthy subjects (28 ml), and they suggested that lower resting volume may be making patients' bile more lithogenic. Our two cholecystitis and one cholangitis patients had SCIs above T10, of which one was at T12.…”

“…4,20,21 One study showed that gall bladder fasting volume and ejection fraction were significantly less in SCI above T10. 20 This may be about that the gall bladder is innervated from T7-T10 segments of the spinal cord. Also in the same study, they have found increased of biliary sludge above T10 SCI patients.…”

Sonographic evaluation of gallbladder contractility in patients with spinal cord injury

“…This finding was attributed to a dysfunction of the spinal sympathetic system. 4,5 An increased prevalence of gallstones in patients with SCI was also attributed to general risk factors such as diabetes mellitus and obesity. 6 In this study, we used sonography to evaluate gallbladder contractility in response to a standard fatty meal in patients with SCI and compared the results with those obtained from healthy control subjects.…”