Related Experiment Videos
Cholelithiasis. Clinical characteristics in children. Case analysis and literature review
1Division of Gastroenterology, Children's Mercy Hospital, Kansas City, Missouri 64108.
Insights
Pediatric cholelithiasis (gallstones) diagnosis relies more on symptoms and medical history than lab tests. Hemolytic disease is a common co-occurring condition, varying with age.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Clinical Medicine
Background:
- Cholelithiasis, or gallstones, is increasingly diagnosed in children.
- Associated conditions and age-specific presentations are crucial for understanding pediatric gallstone disease.
Purpose of the Study:
- To review pediatric cholelithiasis cases diagnosed at a children's hospital.
- To compare these cases with existing literature on pediatric gallstones.
- To identify key diagnostic factors and associated conditions.
Main Methods:
- Retrospective review of 35 pediatric cholelithiasis cases over 7.5 years.
- Comparison with 693 cases from published literature.
Main Results:
- Symptomatology and medical history are more critical for diagnosis than laboratory tests.
- Hemolytic disease is the most frequent associated condition (46% in this series, 30% in literature).
- Jaundice is the primary symptom in infants under 1 year (>90% of symptomatic cases), while vomiting is the most common symptom overall (60% in this series).
Conclusions:
- Clinical presentation and patient history are paramount in diagnosing pediatric gallstones.
- The prevalence of associated conditions in pediatric cholelithiasis varies significantly with patient age.
- Isolated gallstone disease can occur, especially in young infants.
Abstract:
Thirty-five cases of cholelithiasis diagnosed at a children's hospital over a 7.5-year period are reviewed and compared to 693 cases of pediatric gallstones reported in the literature. Symptomatology and associated medical history are more important in diagnosing cholelithiasis than are laboratory tests. Hemolytic disease is the most common associated condition in our series (46%) as well as in the literature (30%), but the frequency of the various associated conditions varies with age. Isolated gallstone disease does occur, particularly in the young infant. Jaundice is the most common symptom in children less than 1 year of age, being present in greater than 90 percent of symptomatic patients previously reported. Overall, the most common symptom in our series is vomiting (60%). Right upper quadrant pain in the absence of vomiting does not appear to be significant, as this occurred in only one patient (3%) in our series.