Significance of sludge and thickened wall in ultrasound evaluation of the gallbladder

Ultrasonography is reliable in detecting the presence of cholelithiasis. Isolated findings of a thickened gallbladder wall or intraluminal sludge (echogenic bile), or both, are regarded as less reliable in the diagnosis of primary gallbladder pathologic factors and are often thought to be indicators of some other pathologic or physiologic process. A retrospective analysis of 72 patients with isolated findings of sludge or thickened wall was performed. Thickened wall remains a non-specific finding. The presence of sludge on ultrasound, when coupled with normal liver function and amylase test results and right upper quadrant pain, correlated with a significant incidence of intrinsic pathologic findings of the gallbladder.