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[Asymptomatic cholelithiasis in an extreme premature child]
1Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
Insights
This case report details an asymptomatic infant with gallstones (cholelithiasis) diagnosed via ultrasound. The condition resolved spontaneously, suggesting watchful waiting may be appropriate for similar pediatric cases.
Area of Science:
- Pediatric Gastroenterology
- Neonatal Medicine
- Diagnostic Imaging
Background:
- Cholelithiasis (gallstones) is rare in infants.
- Infantile cholelithiasis is often linked to hemolytic disease.
- Increased use of ultrasonography aids early diagnosis.
Purpose of the Study:
- To present a case of asymptomatic cholelithiasis in a premature infant.
- To review the literature on pediatric gallstone disease.
- To discuss the potential for spontaneous resolution.
Main Methods:
- Case report of a premature infant (28 weeks gestation).
- Incidental diagnosis of cholelithiasis via routine ultrasonography.
- Comprehensive literature review (Medline, Lilacs) of the past 45 years.
Main Results:
- A 28-week premature infant diagnosed with cholelithiasis at 5 months.
- Identified risk factors included prematurity, total parenteral nutrition, furosemide use, and sepsis.
- The infant remained asymptomatic, and the gallstones resolved spontaneously.
Conclusions:
- Cholelithiasis in children is uncommon and typically associated with specific conditions.
- This case suggests spontaneous resolution is possible for asymptomatic infantile cholelithiasis.
- Ultrasonography facilitates the detection of gallstones in neonates and young infants.
Abstract:
OBJECTIVE: To report a case of asymptomatic cholelithiasis in a premature young infant, presenting literature review. METHODS: The authors describe a case of asymptomatic cholelithiasis, incidentally diagnosed during a routine ultrasonographic exam, with spontaneous resolution. Literature review has been done from Medline and Lilacs, with quotations from articles of the last 45 years. RESULTS: Premature patient 28 weeks old with a cholelithiasis diagnosis at 5 months, presenting the following risk factors: prematurity, total parenteral nutrition, prolonged use of Furosemide and sepsis. The patient remained asymptomatic until the spontaneous resolution occurred. CONCLUSION: Cholelithiasis in childhood has been reported in the literature as a rare condition, usually associated with Hemolytic disease. The widespread use of ultrasonography has contributed to an increase in the diagnosis of neonates and young infants in this condition. This case report highlights the idea of possible spontaneous resolution in cases of asymptomatic cholelithiasis incidentally diagnosed.
