Ultrasonic characteristics of tumefactive biliary sludge: A thixotropic phenomenon

Biliary sludge (or very thick bile) is mainly comprised of calcium bilirubinate granules and lesser amounts of cholesterol crystals, and it can produce a layer of low amplitude of echoes in the most dependent part of the gallbladder (GB). In tumefactive biliary sludge, low-amplitude echoes do not form a fluid–fluid level but instead tend to give the appearance of a polypoid mass that is bounded by a smooth margin, round, and lobulated. Differential diagnoses for an echogenic mass in the GB lumen include GB carcinoma, tumefactive sludge, and gangrenous cholecystitis. In this case report, we describe a rare case in which biliary sludge did not form a fluid–fluid level but tended to accumulate and appear as a polypoid mass within the lumen of the GB. The lesion was finally identified as being tumefactive sludge mimicking neoplasm of the GB.

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“…The gel turns into a solution when the GB is strongly tapped and returns to the gel form when the solution is left at rest. [ 6 ]…”

Section: Discussionmentioning

confidence: 99%

Tumefactive sludge mimicking gallbladder neoplasm: A case report and review of the literature

et al. 2018

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“…In contrast, the relationship of bile duct crystals to sphincter of Oddi dysfunction is not clear (Rhee and Elta 2003). In some patients, sludge in the gallbladder or the common bile duct causes pseudotumorous masses, the so-called tumefactive sludge (Ando and Ito 1986;Kelly et al 1993).…”

Section: Clinical Features Of Sludgementioning

confidence: 99%