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Ceftriaxone-induced pseudolithiasis in children treated for perforated appendicitis
Hanna Alemayehu1, Amita A Desai, Priscilla Thomas
1Department of Surgery, Center for Prospective Clinical Trials, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA.
Pediatric Surgery International
|January 28, 2014
Summary
Ceftriaxone use in children with perforated appendicitis can lead to biliary pseudolithiasis. This condition, characterized by gallbladder stones or sludge, occurred in 14% of patients and was not linked to treatment duration.
Area of Science:
- Pediatric Surgery
- Pediatric Infectious Diseases
- Gastroenterology
Background:
- Ceftriaxone is a commonly used antibiotic in pediatric care.
- Pseudolithiasis, or gallbladder sludge/stones, has been linked to ceftriaxone therapy.
- Perforated appendicitis in children often requires antibiotic treatment, including ceftriaxone.
Purpose of the Study:
- To evaluate the incidence of ceftriaxone-related pseudolithiasis in children treated for perforated appendicitis.
- To determine if the duration of ceftriaxone therapy influences pseudolithiasis development.
Main Methods:
- Retrospective chart review of 71 pediatric patients undergoing laparoscopic appendectomy for perforated appendicitis.
- All patients received post-operative ceftriaxone treatment.
- Gallbladder imaging before and after treatment was analyzed.
Main Results:
- 14% (10 out of 71) of patients developed gallbladder stones or sludge.
- Mean duration of ceftriaxone therapy was 8.7 days.
- No significant difference in treatment duration was found between patients who developed pseudolithiasis and those who did not.
Conclusions:
- Ceftriaxone treatment for perforated appendicitis in children is associated with a significant incidence of biliary pseudolithiasis.
- The development of pseudolithiasis was not dependent on the duration of ceftriaxone therapy.
- One case of symptomatic pseudolithiasis required cholecystectomy.
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