Gallstone disease in women younger than 30 years

The relation between symptomatic cholelithiasis in women under 30 years of age and pregnancy, obesity and oral contraceptive use was retrospectively studied. A total of 885 cholecystectomies were carried out in an English district hospital. In the age group under 30 years the female-male ratio was 9.7:1 vs 2.3:I in the total group (p less than 0.01). Gallstones were present in 39 women with a previous pregnancy and in 14 women without pregnancy. Compared to an age and sex matched control group of appendicectomies a relative risk of 1.6 was found for pregnancy related gallstone disease requiring cholecystectomy (p less than 0.05). 455 Cholecystectomies were carried out in a Dutch academic hospital. The female-male ratio in the group younger than 30 years was 7.0:I vs 2.3:I in the total group (p less than 0.01). In the Dutch group more women under 30 years were operated on than in the English group: 23% vs 10% (p less than 0.001). There was no significant association between symptomatic gallstones and previous pregnancies in the Dutch group (p = 0.07). Gallstone disease occurs earlier in women than in men. There appears to be a relationship between early symptomatic cholelithiasis and pregnancy in the English group only. No relationship could be found between cholelithiasis and obesity or oral contraceptive use in either group.