Gallbladder sludge

Mashako MNL, Cezard JP, Boige N, Chayvialle JA, et al. The effect of artificial feeding on cholestasis, gallbladder sludge and lithiasis in infants correlation with plasma cholecystokinin levels. Clin Nutr 1991 10 320-7. 

Biliary tract The frequencies of gallbladder sludge and cholelithiasis in 25 patients taking tacrolimus and 51 taking ciclosporin have been compared [86 ]. With tacrolimus the incidence of biliary sludge was 4% (1 of 25) and of gallstones 28% (7 of 25) the rates with ciclosporin were 4% (2 of 51) and 25% (13 of 51). 

Table 8.2 summarises some of the conditions in which there is impaired gallbladder motor function and an associated increase in the prevalence of either sludge (which may pre-dispose to stone formation), frank gallstones or both. The role of Octreotide (OT) will now be focused upon since this illustrates the whole sequence of pathogenic changes found in conventional GBS disease -albeit eclipsed into weeks or months. 

Ceftriaxone has been associated with mostly asymptomatic and reversible bihary sludge. The condition is defined by the presence of low amphtude echoes with absent postacoustic shadows in the gallbladder on ultrasonography and has also been called bihary pseudo-lithiasis (100). Findings consistent with the presence of cholehthiasis (high amphtude echoes with acoustic shadowing) have also been reported (101). 

Ceftriaxone does not seem to predispose to subsequent gallbladder stone formation, as assessed 6 and 12 months later (107). The pathogenesis relates to ceftriaxone s high rate of bihary excretion and the subsequent formation of calcium-containing precipitates (108). Thus, apart from the risk factors mentioned above, the risk of biliary sludge... 

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