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Cholelithiasis in children with sickle cell disease
Insights
Gallstones are common in children with sickle cell disease, affecting 17%. Cholecystectomy resolved abdominal pain and crises in these patients.
Area of Science:
- Pediatrics
- Gastroenterology
- Hematology
Background:
- Sickle cell disease (SCD) is a genetic blood disorder associated with various complications.
- Gallstone formation is a known, though not fully understood, complication in SCD patients.
Purpose of the Study:
- To determine the prevalence of gallstones in children with homozygous sickle cell disease.
- To evaluate the clinical presentation and outcomes of gallstone disease in this pediatric population.
Main Methods:
- A cohort of 47 children (ages 2-18) with homozygous sickle cell disease was assessed.
- Diagnostic imaging included oral cholecystography and cholecystosonography.
- Symptomatic patients underwent cholecystectomy and were followed post-operatively.
Main Results:
- Gallstones were identified in 8 out of 47 patients (17%) via both imaging modalities.
- These patients frequently experienced recurrent right upper quadrant abdominal pain, sickle cell abdominal crises, and hepatic crises.
- All eight patients who underwent cholecystectomy were found to have gallstones and remained asymptomatic during 7-17 months of follow-up.
Conclusions:
- Gallstones represent a significant complication in children with homozygous sickle cell disease.
- Cholecystectomy effectively manages symptomatic gallstone disease, resolving abdominal pain and crises in this population.
Abstract:
A group of 47 children with homozygous sickle cell disease ranging in age from 2 to 18 years was studied for the prevalence of gallstones. All of these patients had oral cholecystogram and cholecystosonogram. Eight of the 47 patients (17%) had gallstones both on oral cholecystography and on cholecystosonography. These eight patients had a history of recurrent abdominal pain usually localized to the right upper quadrant. All were admitted on several occasions for sickle cell abdominal crises and four of these were admitted for acute hepatic crisis. These patients have undergone elective cholecystectomy and gallstones were found in every patient. The patients have been followed up from seven to 17 months after cholecystectomy and none have had abdominal symptoms or required hospitalization for abdominal crises.