Gallstones in chronic spinal cord injury: is impaired gallbladder emptying a risk factor?
OBJECTIVE
To confirm that spinal cord injured persons are susceptible to gallstones and to evaluate the role of gallbladder stasis as a risk factor.


METHODS
Twenty-nine subjects with chronic spinal cord injury underwent fasting ultrasonography to determine the incidence of gallstones and to quantitate gallbladder emptying response to a 20g fat liquid meal. Gallbladder emptying fraction was compared to that of healthy subjects studied concurrently.


RESULTS
Gallstones or sludge were found in 6 spinal cord injured men, a minimal prevalence of 21%. Four additional subjects had prior cholecystectomy for stones, giving a potential maximal prevalence of 30%. Four of the 6 subjects had gallstone risk factors of diabetes, obesity, and/or family history. Gallbladder stasis was not apparent in chronic spinal cord injured subjects. Only 5 subjects had poor gallbladder emptying, and 4 of them had diabetes and/or obesity.


CONCLUSIONS
The study confirms an increased prevalence of gallstones after spinal cord injury. However, gallbladder stasis did not appear to be etiologic, and most gallstones were associated with conventional risk factors. The results do not support a general policy of gallstone screening or prophylactic therapy after spinal cord injury.
Ketover
S R
SR
Department of Medicine, Department of Veterans Affairs Medical Center, Minneapolis, MN, USA.
Ansel
H J
HJ
Goldish
G
G
Roche
B
B
Gebhard
R L
RL
D000328:Adult; D002769:Cholelithiasis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D014463:Ultrasonography