CLINICO-SONOGRAPHIC DIAGNOSIS OF BILIARY SLUDGE
Objective. To assess the possibility of increasing the biliary sludge (BS) diagnosis basing on the biliary dysfunction syndrome subjective clinical criteria and the data of the gallbladder transabdominal sonography. Material and methods. Four hundred seventy three patients (265 women and 208 men, mean age 38.63±12.38 yrs) having addressed for medical assistance because of pain in the superior abdominal quadrant were examined. Presence of the biliary dysfunction syndrome was determined basing on subjective clinical criteria evidencing about the gallbladder and Oddy's sphincter functional disorder as stated by Rome Consensus III. BS was diagnosed when hyperechogenic particles suspension, not homogenous sonographically bile containing clots and luting like bile were found in the gallbladder lumen. For determining the BS diagnosis efficiency the results of the clinical symptoms evaluation and the sonographic data were compared with the data obtained in the B-bile microscopy. Results. The subjective clinical criteria of the biliary dysfunction syndrome is expedient to use for BS screening (sensitivity - 85.33%, specificity - 43.40%). The data obtained only in the gallbladder sonography is not sufficient for BS diagnosis (sensitivity - 34.21%, specificity - 90.39%). Revealing of the biliary dysfunction syndrome followed by the gallbladder sonography increases surprisingly the BS diagnosis optimal efficiency (sensitivity - 85.33%, specificity - 73.59%). Conclusion. Determination of subjenctive clinical criteria of the biliary dysfunction syndrome followed by the gallbladder sonography provides the BS diagnosis optimal efficiency.