title: Increased incidence of biliary sludge and normal gall bladder contractility in patients with high spinal cord injury.
abstract: BACKGROUND
  Patients with spinal cord injury (SCI) have an increased prevalence of gallstones.
  
  
  OBJECTIVE
  To study prospectively the incidence of gallstones and gall bladder contractility in patients with SCI.
  
  
  METHODS
  Thirty six consecutive patients with SCI were studied: 18 patients with SCI above thoracic 10 neuronal segment (> T10) and 18 patients with SCI below T10 (< T10). An equal number each of disease controls (multiple fractures) and healthy controls were also studied. All patients and controls underwent serial ultrasonography to detect development of gallstones and ultrasonographic measurement of gall bladder contractility.
  
  
  RESULTS
  A significantly higher number (9/18) of patients with SCI > T10 developed biliary sludge compared with patients with SCI < T10 (2/18), disease controls (2/18), and healthy controls (1/18) (p < 0.05). No patient developed gallstones. The gall bladder fasting volume was significantly decreased in patients with SCI > T10 (20.56 ml; 95% confidence intervals (CI) 19.74 to 21.38) compared with that in patients with SCI < T10 (27.33 ml, 95% CI 26.17 to 28.49; p < 0.05), disease controls (27.92 ml, 95% CI 26.69 to 29.15; p < 0.05), and healthy controls (28.35 ml, 95% CI 27.25 to 29.45; p < 0.05). Gall bladder contractility was normal in patients with SCI as shown by normal gall bladder residual volume and emptying time.
  
  
  CONCLUSIONS
  Patients with SCI above T10 have an increased incidence of biliary sludge and a decreased gall bladder fasting volume. Gall bladder contractility is, however, normal.
authors.affiliation: Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: R K
authors.initials: RK
authors.lastname: Tandon
authors.forename: R K
authors.initials: RK
authors.lastname: Jain
authors.forename: P K
authors.initials: PK
authors.lastname: Garg
mesh_terms: D000328:Adult; D002769:Cholelithiasis / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016473:Gallbladder Emptying; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013997:Time Factors; D014463:Ultrasonography