Biliary Colic Caused by Biliary Sludge

Incidence and Risk Factors

• The estimated incidence of gallstone-related disease, including sludge complications, complicating pregnancy is 0.5-0.8% in the general population, with women with preexisting gallstones, obesity, or elevated serum leptin levels facing increased risk 1
• Post-gastric surgery states are associated with a high prevalence of biliary sludge formation, increasing the baseline risk for subsequent biliary colic 2

Diagnostic and Management Considerations

• In pregnancy, ultrasound remains the imaging modality of choice for evaluating biliary sludge and gallstones, with a high degree of sensitivity and specificity 3
• For pregnant patients, cholecystectomy is safe during pregnancy with a laparoscopic approach being standard of care, ideally performed in the second trimester, as recommended by the American Gastroenterological Association 2, 3