BILIARY SLUDGING IN CRITICALLY ILL TRAUMA PATIENTS

We used serial weekly ultrasonography to prospectively screen 19 criti cally iu trauma victims for the development of biliary sludge, Fourtee n patients had sludge formation during their hospitalization. Sludge d evelopment was positively associated with increased transfusion requir ements, but not with any other laboratory or clinical findings, includ ing injury severity scores. The enteral feedings administered to most patients did not prevent sludge formation in the majority of cases; al l five patients receiving total parenteral nutrition had sludge. Three patients had complications that could possibly be attributed to the s ludge (one case of acalculous cholecystitis and two cases of mild panc reatitis). No such problems occurred in the five patients who did not have sludge, No long-term clinical problems related to sludge have occ urred. We conclude that gallbladder sludge frequently develops in crit ically ill trauma patients and that sludge may be associated with panc reatobiliary complications.