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Outcome of cholelithiasis in Sudanese children with Sickle Cell Anaemia (SCA) after 13 years follow-up
B A I Attalla1, Z A Karrar, G Ibnouf
1Department of Paediatrics, University of Bahri, Khartoum, Sudan. bakhieta@hotmail.com
Insights
Gallstones are common in children with sickle cell anemia (SCA), affecting 11.5% of those studied. Most children with gallstones remained asymptomatic over a 13-year follow-up period.
Area of Science:
- Pediatric Hematology
- Gastroenterology
- Medical Imaging
Background:
- Sickle cell anemia (SCA) is associated with chronic hemolysis, a known risk factor for developing gallstones (cholelithiasis).
- Understanding gallstone prevalence in pediatric SCA patients is crucial for managing potential complications.
Purpose of the Study:
- To investigate the prevalence and clinical outcomes of gallstones in children diagnosed with SCA.
- To assess the long-term impact of cholelithiasis in this specific pediatric population.
Main Methods:
- A prospective study involving 261 children (4 months to 16 years) with SCA.
- Abdominal ultrasound (AUS) was used for gallstone detection, with follow-up AUS examinations.
- Patients diagnosed with gallstones were monitored for clinical outcomes.
Main Results:
- The overall prevalence of cholelithiasis was 11.5%, increasing with age.
- No specific hematological variables, bilirubin levels, or sex predicted higher gallstone risk.
- The majority of affected children remained asymptomatic, with only one requiring surgery over a 13-year follow-up.
Conclusions:
- Cholelithiasis is significantly prevalent in Sudanese children and adolescents with SCA.
- Most pediatric SCA patients with gallstones experience a benign, asymptomatic clinical course over extended periods.
Background:
SCA causes chronic haemolysis which is a risk factor for cholelithiasis.
Objective:
To determine the prevalence and outcome of children with SCA complicated with gallstones treated at the sickle cell clinic at the children emergency hospital Khartoum state.
Methods:
261 patients age 4 months to 16 years were studied. AUS examination was carried out. The 30 patients in whom gall stones were detected followed prospectively from June 1996 to September 2009 when a second AUS examination was obtained.
Results:
Gall stones occurred in 30 patients of whom four were lost to follow up in the first year. The overall prevalence of cholelithiasis was 11.5% and it increased with age. The youngest patient with cholelithiasis was 2 1/2 years old. Haematological variables, bilirubin and sex did not identify a subgroup of patients at higher risk for gallstones. All the patients were asymptomatic at the time of diagnosis. One patient developed symptoms 3years after the diagnosis and he was submitted to surgery. The 25 remaining asymptomatic patients were followed up for 13 years and none of them presented complications related to cholelithiasis during this period.
Conclusion:
The prevalence of cholelithiasis in Sudanese children and adolescents with SCA was significant. The large majority patients remained asymptomatic over a long period.
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