Biliary sludge: A mixture of microscopic particulate matter in bile that occurs when particles of material precipitate from bile. Bile is the fluid that is made by the liver. It is stored in the gallbladder until after a meal, when it passes out of the gallbladder and through the common bile duct into the intestine to help digest fat in the meal.
The composition of biliary sludge varies. The most common particulate components of biliary sludge are cholesterol crystals and calcium salts.
Biliary sludge has been associated with certain conditions including rapid weight loss, fasting, pregnancy, medication use (ceftriaxone, octreotide), and bone marrow or solid organ transplantation. However it most commonly occurs in individuals with no identifiable condition.
Biliary sludge can be looked upon as a condition of microscopic gallstones, although it is not clear at what size the particles in biliary sludge should be considered gallstones.
Biliary sludge usually causes no symptoms and may appear and disappear over time. However, there may be intermittent symptoms and, on occasion, the particles may grow in size and become gallstones.
The most common symptom of biliary sludge is pain in the abdomen, often associated with nausea and vomiting. This occurs when the particles obstruct the ducts leading from the gallbladder to the intestine.
Biliary sludge may cause more serious complications, including inflammation of the pancreas (pancreatitis) and inflammation of the gallbladder (cholecystitis).
Biliary sludge can be detected with ultrasound of the abdomen or by directly examining bile contents under a microscope (bile microscopy).
If patients with biliary sludge develop symptoms or complications, gallbladder removal (cholecystectomy) is performed as treatment.