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Article: Biliary sludge

TitleBiliary sludge
Authors
KeywordsReferences (113) View In Table Layout
Issue Date1999
PublisherAmerican College of Physicians. The Journal's web site is located at http://www.annals.org
Citation
Annals Of Internal Medicine, 1999, v. 130 n. 4 I, p. 301-311 How to Cite?
AbstractBiliary sludge was first described with the advent of ultrasonography in the 1970s. It is defined as a mixture of particulate matter and bile that occurs when solutes in bile precipitate. Its composition varies, but cholesterol monohydrate crystals, calcium bilirubinate, and other calcium salts are the most common components. The clinical course of biliary sludge varies, and complete resolution, a waxing and waning course, and progression to gallstones are all possible outcomes. Biliary sludge may cause complications, including biliary colic, acute pancreatitis, and acute cholecystitis. Clinical conditions and events associated with the formation of biliary sludge include rapid weight loss, pregnancy, ceftriaxone therapy, octreotide therapy, and bone marrow or solid organ transplantation. Sludge may be diagnosed on ultrasonography or bile microscopy, and the optimal diagnostic method depends on the clinical setting. This paper proposes a protocol for the microscopic diagnosis of sludge. There are no proven methods for the prevention of sludge formation, even in high-risk patients, and patients should not be routinely monitored for the development of sludge. Asymptomatic patients with sludge can be managed expectantly. If patients with sludge develop symptoms or complications, cholecystectomy should be considered as the definitive therapy. Further studies of the pathogenesis, natural history, and clinical associations of biliary sludge will be essential to our understanding of gallstones and other biliary tract abnormalities.
Persistent Identifierhttp://hdl.handle.net/10722/92487
ISSN
2015 Impact Factor: 16.44
2015 SCImago Journal Rankings: 5.378
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKo, CWen_HK
dc.contributor.authorSekijima, JHen_HK
dc.contributor.authorLee, SPen_HK
dc.date.accessioned2010-09-17T10:47:45Z-
dc.date.available2010-09-17T10:47:45Z-
dc.date.issued1999en_HK
dc.identifier.citationAnnals Of Internal Medicine, 1999, v. 130 n. 4 I, p. 301-311en_HK
dc.identifier.issn0003-4819en_HK
dc.identifier.urihttp://hdl.handle.net/10722/92487-
dc.description.abstractBiliary sludge was first described with the advent of ultrasonography in the 1970s. It is defined as a mixture of particulate matter and bile that occurs when solutes in bile precipitate. Its composition varies, but cholesterol monohydrate crystals, calcium bilirubinate, and other calcium salts are the most common components. The clinical course of biliary sludge varies, and complete resolution, a waxing and waning course, and progression to gallstones are all possible outcomes. Biliary sludge may cause complications, including biliary colic, acute pancreatitis, and acute cholecystitis. Clinical conditions and events associated with the formation of biliary sludge include rapid weight loss, pregnancy, ceftriaxone therapy, octreotide therapy, and bone marrow or solid organ transplantation. Sludge may be diagnosed on ultrasonography or bile microscopy, and the optimal diagnostic method depends on the clinical setting. This paper proposes a protocol for the microscopic diagnosis of sludge. There are no proven methods for the prevention of sludge formation, even in high-risk patients, and patients should not be routinely monitored for the development of sludge. Asymptomatic patients with sludge can be managed expectantly. If patients with sludge develop symptoms or complications, cholecystectomy should be considered as the definitive therapy. Further studies of the pathogenesis, natural history, and clinical associations of biliary sludge will be essential to our understanding of gallstones and other biliary tract abnormalities.en_HK
dc.languageengen_HK
dc.publisherAmerican College of Physicians. The Journal's web site is located at http://www.annals.orgen_HK
dc.relation.ispartofAnnals of Internal Medicineen_HK
dc.subjectReferences (113) View In Table Layouten_HK
dc.titleBiliary sludgeen_HK
dc.typeArticleen_HK
dc.identifier.emailLee, SP: sumlee@hku.hken_HK
dc.identifier.authorityLee, SP=rp01351en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid10068389-
dc.identifier.scopuseid_2-s2.0-0033574026en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0033574026&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume130en_HK
dc.identifier.issue4 Ien_HK
dc.identifier.spage301en_HK
dc.identifier.epage311en_HK
dc.identifier.isiWOS:000078587200008-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridKo, CW=7202596492en_HK
dc.identifier.scopusauthoridSekijima, JH=6506103215en_HK
dc.identifier.scopusauthoridLee, SP=7601417497en_HK

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