Gallbladder sludge (also known as biliary sand, biliary sediment, or thick bile) is a mixture of particulate matter and bile, normally seen as a liquid-liquid level in the gallbladder on ultrasound, corresponding to the precipitate of bile solutes 1.
These precipitates consist of cholesterol monohydrate crystals, calcium bilirubinate granules, calcium salts and mucus secreted by the gallbladder 1.
On ultrasound, gallbladder sludge appears as a low amplitude homogeneous echoes, layering on the posterior wall. It moves slowly with changes in patient position.
Small amounts of gallbladder sludge may mimic gallstones (so called "tumefactive sludge") but sludge does not cause shadowing, unless associated with gallstones 2. Large amounts of tumefactive sludge may mimic a mass.
- galllbladder wall abnormalities
- diffuse gallbladder wall thickening (differential)
- focal gallbladder wall thickening (differential)
- gallbladder polyps
- gallbladder malignancy
- porcelain gallbladder
- gallbladder inflammation
- other gallbladder abnormalities
- 1. Shaffer EA. Gallbladder sludge: what is its clinical significance?. Curr Gastroenterol Rep. 2003;3 (2): 166-73. Pubmed citation
- 2. Ferreira, Adilson Cunha et al. Fatores de risco clínicos e ultra-sonográficos relacionados à litíase vesicular assintomática em mulheres. Radiol Bras [online]. 2004, vol.37, n.2 [cited 2013-02-04], pp. 77-82 . Available from: . ISSN 0100-3984. http://dx.doi.org/10.1590/S0100-39842004000200004.
- 3. Catalano OA, Sahani DV, Kalva SP et-al. MR imaging of the gallbladder: a pictorial essay. Radiographics. 2008;28 (1): 135-55. Radiographics (full text) - doi:10.1148/rg.281065183 - Pubmed citation