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Conference Paper: Pathogenesis of biliary sludge

TitlePathogenesis of biliary sludge
Authors
Issue Date1990
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/
Citation
Hepatology, 1990, v. 12 n. 3 II, p. 200S-205S How to Cite?
AbstractThe increasing application of ultrasonography in biliary tract disease had led to more frequent recognition of an old disorder - ''biliary sludge.'' Sludge is detected on ultrasound as low-amplitude echoes without acoustic shadowing. It layers in the most dependent part of the gallbladder and shifts with positioning. Particulate matter in bile, such as cholesterol monohydrate crystals, has been shown to be echogenic. Agglomeration of these crystals in biles with high mucus content accounts for the layering and the characteristic appearance of the movement of sludge with alteration in patient position. Within the gallbladder, the stability of the vesicular form of cholesterol and protein-lipid interactions are important determinants of cholesterol precipitation. In mixed and pigment gallstones, the equilibrium between ionized and unionized calcium and the hydrolysis of conjugated bilirubin are also important factors. Although the risk factors contributing to the formation of gallbladder sludge have not been critically examined, it is now known that in some instances sludge can produce biliary pain and can be associated with acalculous cholecystitis, recurrent pancreatitis and, ultimately, the formation of gallstones. A better appreciation of the pathogenesis of sludge formation can help in the understanding of the genesis of gallstones and also perhaps in understanding other documented but poorly understood biliary and pancreatic disorders.
Persistent Identifierhttp://hdl.handle.net/10722/176086
ISSN
2015 Impact Factor: 11.711
2015 SCImago Journal Rankings: 4.752
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLee, SPen_US
dc.date.accessioned2012-11-26T09:05:32Z-
dc.date.available2012-11-26T09:05:32Z-
dc.date.issued1990en_US
dc.identifier.citationHepatology, 1990, v. 12 n. 3 II, p. 200S-205Sen_US
dc.identifier.issn0270-9139en_US
dc.identifier.urihttp://hdl.handle.net/10722/176086-
dc.description.abstractThe increasing application of ultrasonography in biliary tract disease had led to more frequent recognition of an old disorder - ''biliary sludge.'' Sludge is detected on ultrasound as low-amplitude echoes without acoustic shadowing. It layers in the most dependent part of the gallbladder and shifts with positioning. Particulate matter in bile, such as cholesterol monohydrate crystals, has been shown to be echogenic. Agglomeration of these crystals in biles with high mucus content accounts for the layering and the characteristic appearance of the movement of sludge with alteration in patient position. Within the gallbladder, the stability of the vesicular form of cholesterol and protein-lipid interactions are important determinants of cholesterol precipitation. In mixed and pigment gallstones, the equilibrium between ionized and unionized calcium and the hydrolysis of conjugated bilirubin are also important factors. Although the risk factors contributing to the formation of gallbladder sludge have not been critically examined, it is now known that in some instances sludge can produce biliary pain and can be associated with acalculous cholecystitis, recurrent pancreatitis and, ultimately, the formation of gallstones. A better appreciation of the pathogenesis of sludge formation can help in the understanding of the genesis of gallstones and also perhaps in understanding other documented but poorly understood biliary and pancreatic disorders.en_US
dc.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/en_US
dc.relation.ispartofHepatologyen_US
dc.subject.meshAnimalsen_US
dc.subject.meshBile - Metabolismen_US
dc.subject.meshBiliary Tract Diseases - Diagnosis - Etiology - Metabolismen_US
dc.subject.meshChemical Precipitationen_US
dc.subject.meshCholesterol - Metabolismen_US
dc.subject.meshCrystallizationen_US
dc.subject.meshGallbladder - Metabolismen_US
dc.subject.meshGallbladder Diseases - Diagnosis - Metabolismen_US
dc.subject.meshHumansen_US
dc.subject.meshModels, Biologicalen_US
dc.subject.meshParticle Sizeen_US
dc.subject.meshUltrasonographyen_US
dc.titlePathogenesis of biliary sludgeen_US
dc.typeConference_Paperen_US
dc.identifier.emailLee, SP: sumlee@hku.hken_US
dc.identifier.authorityLee, SP=rp01351en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid2210650-
dc.identifier.scopuseid_2-s2.0-0025052613en_US
dc.identifier.volume12en_US
dc.identifier.issue3 IIen_US
dc.identifier.spage200Sen_US
dc.identifier.epage205Sen_US
dc.identifier.isiWOS:A1990EC79000030-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridLee, SP=7601417497en_US

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