Sonography of the gallbladder in bone marrow transplant patients

Nonshadowing opacities in the gallbladder (sludge) occurred in nine of 44 bone marrow transplant patients as a nonspecific finding. Sludge occurring within 2 wk of bone marrow transplant was transient. Later, sludge accompanied hepatic graft versus host disease in seven of 10 patients with this complication of bone marrow transplant. During the course of graft versus host disease, disappearance of sludge matched clinical improvement. Persistence of sludge in patients with hepatic graft versus host disease was associated with a poor prognosis. The gallbladder of one patient who underwent cholecystectomy exhibited histopathologic findings of graft versus host disease.