Cholelithiasis in childhood and adolescence. A review

Cholelithiasis and cholecystitis are uncommon in childhood and adolescence. Misconceptions as to the aetiology, natural history, diagnosis, and therapy of these conditions prompted us to review our experience. Nineteen patients ranging in age from 7 to 18 years underwent cholecystectomy for gallstones at the University of Illinois Hospital, Chicago, between June 1970 and June 1979. Seventeen patients were female and 2 male (ratio 8.5:1). The cause was unknown in 12 patients (63%) but in 7 patients (37%) haematological disease was the underlying disorder. The most common presenting symptom (95%) was vague right upper quadrant or epigastric pain, often ignored or mistaken for peptic ulcer pain. Oral cholecystography demonstrated gallstones in 15 of 16 patients. Ultrasonography, used more recently, was positive in 3 patients intra-operative cholangiography in 12 patients, and common duct exploration in 1 additional patient, failed to demonstrate calculi. No patients were readmitted for recurrent or retained biliary calculi after cholecystectomy.