GALLSTONES IN CHRONIC SPINAL-CORD INJURY - IS IMPAIRED GALLBLADDER EMPTYING A RISK FACTOR

Objectives: To confirm that spinal cord injured persons are susceptibl e to gallstones and to evaluate the role of gallbladder stasis as a ri sk factor. Study Design: Twenty-nine subjects with chronic spinal cord injury underwent fasting ultrasonography to determine the incidence o f 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 gall stone risk factors of diabetes, obesity, and/or family history. Gallbl adder stasis was not apparent in chronic spinal cord injured subjects. Only 5 subjects had poor gallbladder emptying, and 4 of them had diab etes and/or obesity. Conclusions: The study confirms an increased prev alence of gallstones after spinal cord injury. However, gallbladder st asis did not appear to be etiologic, and most gallstones were associat ed with conventional risk factors. The results do not support a genera l policy of gallstone screening or prophylactic therapy after spinal c ord injury.