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Biliary sludge in sickle cell disease

T M Walker1, G R Serjeant

  • 1Department of Radiology, Royal Berkshire Hospital, Reading, England.

The Journal of Pediatrics
|September 1, 1996
PubMed
Summary
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Biliary sludge, a gallbladder condition, was found in sickle cell disease patients. Most cases were asymptomatic, suggesting conservative management may be appropriate for this patient group.

Area of Science:

  • Gastroenterology
  • Hematology
  • Clinical Medicine

Background:

  • Sickle cell disease (SCD) is associated with an increased risk of gallstone formation.
  • Biliary sludge is a precursor to gallstones and can also occur independently.

Purpose of the Study:

  • To investigate the prevalence and clinical significance of biliary sludge in patients with sickle cell disease.
  • To evaluate the natural history and management of biliary sludge in this cohort.

Main Methods:

  • A cohort study of 429 patients with sickle cell disease was conducted.
  • Patients were monitored for the development of biliary sludge and gallstones.
  • Clinical symptoms related to biliary tract disease were assessed.

Main Results:

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  • Biliary sludge was detected in 17 out of 429 SCD patients (3.96%).
  • Of the 17 patients with biliary sludge, 12 later developed gallstones, while 5 did not.
  • None of the patients with biliary sludge experienced symptomatic biliary tract disease, and none required cholecystectomy.

Conclusions:

  • Biliary sludge is a relatively common finding in patients with sickle cell disease.
  • In this cohort, biliary sludge and subsequent gallstone formation in SCD patients were largely asymptomatic.
  • Conservative management, similar to that for asymptomatic gallstones, appears to be a safe and effective approach for biliary sludge in Jamaican SCD patients.