link
Bookmarks
Gallstones and Sludge
Siva P. Raman, MD
To access 4,300 diagnoses written by the world's leading experts in radiology, please log in or subscribe.Log inSubscribe
0
18
2
3

KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Gallstones: Biliary stone, cholelithiasis, choledocholithiasis
            • Sludge: Biliary sludge, microlithiasis, biliary sand, pseudolithiasis, microcrystalline disease
          • Definitions

            • Gallstones: Concretions within biliary system (gallbladder [GB] and biliary ducts)
              • Cholesterol stone (75-80%): Cholesterol is main constituent
              • Pigment stone (20-25%): Calcium-bilirubinate is main constituent
                • Black stone: Usually pigment stone in sterile GB; small and tar-like stones frequently associated with cirrhosis and hemolytic states
                • Brown stone: Usually pigment stone in infected bile duct, associated with cholestasis and biliary infections (e.g., recurrent pyogenic cholangitis)
            • Choledocholithiasis: Stones in common bile duct (CBD)
            • Sludge: Suspension of particulate material/bile in GB

          IMAGING

          • General Features

            • Imaging Recommendations

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Fluoroscopic Findings

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    Selected References

                                    1. Luu MB et al: Unusual complications of gallstones. Surg Clin North Am. 94(2):377-94, 2014
                                    2. Raman SP et al: Abnormalities of the distal common bile duct and ampulla: Diagnostic approach and differential diagnosis using multiplanar reformations and 3D imaging. AJR Am J Roentgenol. 203(1):17-28, 2014
                                    3. Yarmish GM et al: ACR appropriateness criteria right upper quadrant pain. J Am Coll Radiol. 11(3):316-22, 2014
                                    4. Lubarsky M et al: MR Imaging for Acute Nontraumatic Abdominopelvic Pain: Rationale and Practical Considerations. Radiographics. 33(2):313-37, 2013
                                    5. Bergman S et al: Gallstone disease in the elderly: are older patients managed differently? Surg Endosc. 25(1):55-61, 2011
                                    6. Bär F et al: Gallstone ileus. Clin Gastroenterol Hepatol. 9(10):A22, 2011
                                    7. Gurusamy K et al: Systematic review and meta-analysis of intraoperative versus preoperative endoscopic sphincterotomy in patients with gallbladder and suspected common bile duct stones. Br J Surg. 98(7):908-16, 2011
                                    8. Yeh BM et al: MR imaging and CT of the biliary tract. Radiographics. 29(6):1669-88, 2009
                                    9. Catalano OA et al: MR imaging of the gallbladder: a pictorial essay. Radiographics. 28(1):135-55; quiz 324, 2008
                                    10. Chan WC et al: Gallstone detection at CT in vitro: effect of peak voltage setting. Radiology. 241(2):546-53, 2006
                                    11. Bortoff GA et al: Gallbladder stones: imaging and intervention. Radiographics. 20(3):751-66, 2000
                                    12. Ko CW et al: Biliary sludge. Ann Intern Med. 130(4 Pt 1):301-11, 1999
                                    13. Barakos JA et al: Cholelithiasis: evaluation with CT. Radiology. 162(2):415-8, 1987
                                    Related Anatomy
                                    Loading...
                                    Related Differential Diagnoses
                                    Loading...
                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Clinical Issues

                                            TERMINOLOGY

                                            • Synonyms

                                              • Gallstones: Biliary stone, cholelithiasis, choledocholithiasis
                                              • Sludge: Biliary sludge, microlithiasis, biliary sand, pseudolithiasis, microcrystalline disease
                                            • Definitions

                                              • Gallstones: Concretions within biliary system (gallbladder [GB] and biliary ducts)
                                                • Cholesterol stone (75-80%): Cholesterol is main constituent
                                                • Pigment stone (20-25%): Calcium-bilirubinate is main constituent
                                                  • Black stone: Usually pigment stone in sterile GB; small and tar-like stones frequently associated with cirrhosis and hemolytic states
                                                  • Brown stone: Usually pigment stone in infected bile duct, associated with cholestasis and biliary infections (e.g., recurrent pyogenic cholangitis)
                                              • Choledocholithiasis: Stones in common bile duct (CBD)
                                              • Sludge: Suspension of particulate material/bile in GB

                                            IMAGING

                                            • General Features

                                              • Imaging Recommendations

                                                • Radiographic Findings

                                                  • CT Findings

                                                    • MR Findings

                                                      • Ultrasonographic Findings

                                                        • Fluoroscopic Findings

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              CLINICAL ISSUES

                                                              • Presentation

                                                                • Demographics

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      Selected References

                                                                      1. Luu MB et al: Unusual complications of gallstones. Surg Clin North Am. 94(2):377-94, 2014
                                                                      2. Raman SP et al: Abnormalities of the distal common bile duct and ampulla: Diagnostic approach and differential diagnosis using multiplanar reformations and 3D imaging. AJR Am J Roentgenol. 203(1):17-28, 2014
                                                                      3. Yarmish GM et al: ACR appropriateness criteria right upper quadrant pain. J Am Coll Radiol. 11(3):316-22, 2014
                                                                      4. Lubarsky M et al: MR Imaging for Acute Nontraumatic Abdominopelvic Pain: Rationale and Practical Considerations. Radiographics. 33(2):313-37, 2013
                                                                      5. Bergman S et al: Gallstone disease in the elderly: are older patients managed differently? Surg Endosc. 25(1):55-61, 2011
                                                                      6. Bär F et al: Gallstone ileus. Clin Gastroenterol Hepatol. 9(10):A22, 2011
                                                                      7. Gurusamy K et al: Systematic review and meta-analysis of intraoperative versus preoperative endoscopic sphincterotomy in patients with gallbladder and suspected common bile duct stones. Br J Surg. 98(7):908-16, 2011
                                                                      8. Yeh BM et al: MR imaging and CT of the biliary tract. Radiographics. 29(6):1669-88, 2009
                                                                      9. Catalano OA et al: MR imaging of the gallbladder: a pictorial essay. Radiographics. 28(1):135-55; quiz 324, 2008
                                                                      10. Chan WC et al: Gallstone detection at CT in vitro: effect of peak voltage setting. Radiology. 241(2):546-53, 2006
                                                                      11. Bortoff GA et al: Gallbladder stones: imaging and intervention. Radiographics. 20(3):751-66, 2000
                                                                      12. Ko CW et al: Biliary sludge. Ann Intern Med. 130(4 Pt 1):301-11, 1999
                                                                      13. Barakos JA et al: Cholelithiasis: evaluation with CT. Radiology. 162(2):415-8, 1987