Common bile duct calculi in infants and children

Of 62 infants and children undergoing biliary tract operations 4 had common bile duct stones. The primary diseases in the four patients were inspissated bile plug, correctable biliary atresia, neonatal hepatitis, and choledochal cyst, respectively. Biliary obstruction secondary to choledocholiths was total or near total in three patients. Nevertheless, diagnosis was unsuspected, leading to major delays in treatment and probably, irreversible liver damage in two patients. The stones were pigmented in all instances; their genesis believed to be a consequence of hemolysis in three patients and infection in one. Surgical extraction of the biliary calculi was successful by standard methods. All patients are currently alive; one by virtue of liver transplantation. Infants and children with chronic liver disease or biliary tract malformations are predisposed to formation of biliary calculi.