Ultrasound detected asymptomatic cholelithiasis: an age-based protocol for management

This study was undertaken to examine the correlation between age and gender and the presence of ultrasound findings of acute or chronic cholecystitis in adultpatients with cholelithiasis.

The demographic data of all patients diagnosed with cholelithiasis and cholecystitis on ultrasound between January 1, 2002 and December 31, 2006 were reviewed and statistically analysed.

Five hundred adults, 373 females (74.6%) and 127 males (25.4%), were diagnosed with cholelithiasis during the five-year period. Ages ranged from 18 to 94 years with a median age of 47 years. The diagnosis of cholecystitis was equivocal in 11 patients. Of the remaining 489, 22.1% (108) were diagnosed as positive for cholecystitis by ultrasound, the remaining 77.9% (381) being negative. No association was found between gender and cholecysytitis in bivariate analysis, (chi2 = 1.82, df =1, p = 0.177). A statistically significant relation was found between age group category and ultrasound-determined cholecystitis status (chi2 = 32.58, df= 4, p < 0.001). Higher proportions of persons in the 20-39-year (40.9%) and 40-59-year (20.4%) age groups had cholecystitis on ultrasound examination compared to other age categories where corresponding rates were approximately 11% or less.

Patients 60 years or older who were diagnosed with cholelithiasis on ultrasound examination were less likely to have cholecystitis than younger patients.