Sonographically determined clues to the symptomatic or silent cholelithiasis.
OBJECTIVE
To determine an association between sonographically determined contractility with the symptomatic or silent nature of gallstone. Designing: Comparative, cross-sectional study.


METHODS
Radiology Department, Dow University of Health Sciences (DUHS) and Civil Hospital, Karachi (CHK), from April 2004 to March 2005.


METHODS
Adult gallstone patients without (group I) and with biliary symptoms (group II) were compared with age and gender-matched controls. Demographic data, body mass index, risk factors, size, number and mobility of gallstone, gallbladder wall thickness (GBWT), volume and Ejection Fraction (EF) were determined on ultrasound before and after a standardized fatty meal (BFM and AFM). Demographic data, risk factors and gallstone characteristics were analyzed by Pearson Chi-square test and the gallbladder characteristics were analyzed by One-way ANOVA and Post Hoc tests by multiple comparisons on SPSS 11 with significance p=0.05.


RESULTS
The gallbladder contractility as measured by changes in wall thickness and volume changes BFM and AFM, and ejection fraction was similar in controls and asymptomatic cholelithiasis groups and significantly reduced in symptomatic patients (p < .001). Multiparity (p=0.002), female gender (p=0.018), age less than 50 years (0.05), impacted calculi (p=0.001), multiple calculi (< .001) and calculi 5mm (p < 0.001) were associated with pain.


CONCLUSIONS
A sluggishly emptying gallbladder was more significantly associated with symptomatic cholelithiasis compared to controls and asymptomatic cholelithiasis state in this series. Consideration of age, gender, impaction of calculi, number and size of calculi is important in causing symptom state and management options.
Sohail
Saba
S
Department of Radiology, Dow University of Health Sciences and Civil Hospital, Baba-e-Urdu Road, Karachi.
Iqbal
Zahid
Z