Cholecystitis and cholelithiasis in children and adolescents

One hundred patients aged 20 years and younger, admitted to Hurley Medical Center during a ten-year period for treatment of acute or chronic cholecystitis with or without cholelithiasis, were reviewed. Results demonstrated an increasing incidence of pediatric cases compared with previous reports, a predominance in parous teenagers, and only an 8 percent association with hemolytic diseases. The clinical presentation is very similar to that of adults. Maintaining a high index of suspicion in addition to the use of diagnostic aids such as cholecystogram, ultrasonography, and hepatobiliary imaging with technetium 99m PIPIDA (paraisopropylacetanilide iminoacetate) should lead to the diagnosis of gallbladder disease even at a very early age. Elective cholecystectomy in the stable patient is the treatment of choice, and any delays in the diagnosis and treatment will increase morbidity and mortality considerably.