Second harmonic imaging improves trans‐abdominal ultrasound detection of biliary sludge in ‘idiopathic’ pancreatitis

Ierardi, Enzo; Muscatiello, Nicola; Nacchiero, Maurizio Cosimo; Gentile, Micaela; Margiotta, M.; Marangi, Stefania; Francesco, Vincenzo De; Francavilla, Ruggiero; Barone, M.; Faleo, D.; Pañella, C.; Francavilla, A.; Cuomo, Rosario

doi:10.1046/j.1365-2036.2003.01435.x

Cited by 4 publications

(1 citation statement)

References 30 publications

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“…Moreover, other entities such as blood, necrotic debris, multiple small gallstones, or pus can appear similar to sludge [2]. New ultrasound scanners employing second harmonic imaging may lead to improved detection of sludge [7]. Microscopic examination of gallbladder contents is considered the gold standard for the diagnosis of biliary sludge.…”

Section: Introductionmentioning

confidence: 99%

Biliary sludge: When should it not be ignored

Jain

2004

Curr Treat Options Gastro

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Biliary sludge is usually seen on transabdominal sonography as low-level echoes that layer in the dependent portion of the gallbladder without acoustic shadowing. Synonyms for biliary sludge include microlithiasis, biliary sand or sediment, pseudolithiasis, and microcrystalline disease. In most patients, biliary sludge is composed of calcium bilirubinate and cholesterol monohydrate crystals. A variety of predisposing factors are associated with biliary sludge formation. In most of these patients, removal of the risk factor can lead to resolution of sludge. In asymptomatic patients, biliary sludge can be managed expectantly. In patients who develop biliary-type pain, cholecystitis, cholangitis, or pancreatitis, the treatment of choice is cholecystectomy for those who can tolerate surgery. In patients who are not operative candidates, endoscopic sphincterotomy can prevent further episodes of cholangitis and pancreatitis, whereas medical therapy with ursodeoxycholic acid can prevent sludge formation and recurrent acute pancreatitis.

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Section: Introductionmentioning

confidence: 99%

Biliary sludge: When should it not be ignored

Jain

2004

Curr Treat Options Gastro

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Leitlinienreport zur aktualisierten S3-Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV) zur Prävention, Diagnostik und Behandlung von Gallensteinen

Jansen

Gutt²,

Jenssen

et al. 2018

Z Gastroenterol

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Severity of Gallstone-, Sludge-, or Microlithiasis-Induced Pancreatitis—All of the Same?

Sirtl,

Bretthauer,

Ahmad

et al. 2024

Pancreas

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Background/Aim Severity of microlithiasis and sludge-induced pancreatitis in comparison to gallstone-induced pancreatitis has never been studied for a lack of definition. In order to understand whether bile duct obstruction or other mechanisms contribute to biliary pancreatitis severity we performed a monocentric, retrospective cohort study. Methods In this retrospective cohort study 263 patients with acute biliary pancreatitis treated at a tertiary care center from 2005 to 2021 were stratified according to the recent consensus definition for microlithiasis and sludge. The gallstone-pancreatitis cohort was compared to microlithiasis, sludge and suspected stone passage pancreatitis cohorts in terms of pancreatitis outcome, liver function and EUS/ERCP results using one-way ANOVA and Chi2 test. Multinomial logistic regression analysis was performed to correct for bias. Results Microlithiasis and sludge-induced pancreatitis classified according to the revised Atlanta classification, did not present with a milder course than gallstone-induced pancreatitis (p = 0.62). Microlithiasis and sludge showed an increase in bilirubin on the day of admission to hospital, which was not significantly different from gallstone-induced pancreatitis (p = 0.36). The likelihood of detecting biliary disease on EUS resulting in bile duct clearance was highest on the day of admission and day 1, respectively. Conclusion Microlithiasis and sludge induce gallstone-equivalent impaired liver function tests and induce pancreatitis with similar severity compared with gallstone-induced acute biliary pancreatitis.

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Second harmonic imaging improves trans‐abdominal ultrasound detection of biliary sludge in ‘idiopathic’ pancreatitis

Cited by 4 publications

References 30 publications

Biliary sludge: When should it not be ignored

Biliary sludge: When should it not be ignored

Leitlinienreport zur aktualisierten S3-Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV) zur Prävention, Diagnostik und Behandlung von Gallensteinen

Severity of Gallstone-, Sludge-, or Microlithiasis-Induced Pancreatitis—All of the Same?

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