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Cholelithiasis in children: recent observations
Insights
Gallstones (cholelithiasis) are more common in children than previously thought, often linked to underlying health conditions. This study identified 52 pediatric cases, highlighting the need for awareness in pediatric care.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Epidemiology
Background:
- Cholelithiasis (gallstones) is increasingly recognized in pediatric populations.
- Previous data suggested gallstones were rare in children, necessitating further investigation.
Purpose of the Study:
- To determine the incidence and predisposing factors of cholelithiasis in pediatric patients.
- To analyze the characteristics of gallstones identified in children.
Main Methods:
- Retrospective review of medical records for pediatric patients with ultrasonic evidence of cholelithiasis.
- Analysis of patient charts, radiographs, and surgical/pathologic reports.
- Inclusion criteria: patients aged 3 months to 21 years with confirmed gallstones.
Main Results:
- 52 pediatric patients (29 female, 23 male) diagnosed with cholelithiasis over three years.
- 83% of cases had predisposing conditions, including hemolytic anemia, cystic fibrosis, and liver disease.
- Gallstones were visible on radiographs in over 53% of cases, suggesting a mixed composition.
Conclusions:
- Cholelithiasis is more prevalent in children than previously assumed.
- Identifying predisposing factors is crucial for managing pediatric gallstone disease.
- Radiographic visibility indicates a significant proportion of calcium-containing gallstones.
Abstract:
All patients at Children's Hospital Medical Center who had ultrasonic evidence of cholelithiasis during the period from June 1979 to June 1982 were identified. Their charts and radiographs were reviewed, as were the surgical and pathologic reports of those who had cholecystectomy. Cholelithiasis was found to be less rare than expected. Sixty-five patients were identified during the three-year period. Exclusion of 13 patients more than 21 years old left 52 patients, 29 of whom were female and 23 male, ranging in age from 3 months to 21 years. Predisposing diseases or circumstances were present in 83 per cent of the cases. These included hemolytic anemia (15), cystic fibrosis (4), metabolic disease (3), liver disease (4), postpartum state (4), prior bowel resection or malabsorption (4), cardiac disease (4), prior orthopedic surgery (2), other (3). There were only nine cases in which no identifiable predisposition to cholelithiasis could be found. Although the gallstones were not subjected to chemical analysis, at least 53 per cent of them were visible on the 34 available abdominal radiographs, indicating the presence of calcium and thus stones of a mixed type.
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