Cholelithiasis and biliary tract disease in sickle-cell disease in Nigerians

The incidence of biliary tract disease was investigated by oral cholecystography and/or intravenous cholangiography in 77 unselected Nigerians with homozygous sickle-cell disease (SCD). They included 32 males and 45 females with ages ranging from 8 to 31 years. The prevalence of cholelithiasis was 9% with equal sex incidence. The stones were always multiple and 71.4% of them were radio opaque. Visualization and contractility of all gall bladders examined were normal. The only patient with symptoms and signs which suggested biliary tract disease had no radiographic evidence of cholelithiasis and it was impossible to predict the presence of cholelithiasis from the incidence of abdominal crises in the patients. The prevalence of cholelithiasis is significantly less than that reported in American patients with SCD (35%) and different dietary habits are probably responsible for this.