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[Biliary calculi in infancy and childhood]
Insights
This study on pediatric cholelithiasis found that gallstones in infants often resolve spontaneously. In older children, vague abdominal pain is common, and Ursodeoxycholicacid aided stone dissolution in some cases.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Medical Imaging
Background:
- Cholelithiasis (gallstones) in children is increasingly recognized.
- Predisposing conditions significantly influence gallstone formation in pediatric patients.
- Infantile gallstones often differ in etiology and natural history compared to older children.
Purpose of the Study:
- To analyze the clinical characteristics and outcomes of cholelithiasis in a cohort of 48 children.
- To differentiate between gallstones associated with predisposing diseases and those without.
- To evaluate the efficacy of Ursodeoxycholicacid and the role of ultrasound in pediatric gallstone management.
Main Methods:
- Retrospective analysis of 48 pediatric patients diagnosed with cholelithiasis.
- Classification into two groups: Group I (with predisposing diseases) and Group II (without identified predisposing diseases).
- Utilized ultrasound for diagnosis and follow-up; assessed treatment outcomes including Ursodeoxycholicacid therapy and surgical intervention.
Main Results:
- Gallstones in infants frequently developed secondary to underlying conditions and showed spontaneous dissolution.
- Vague abdominal pain was the predominant symptom in children without predisposing diseases (Group II).
- Ursodeoxycholicacid facilitated gallstone dissolution in two patients in Group II; surgical intervention rates differed between groups.
Conclusions:
- Cholelithiasis in children presents differently based on the presence of predisposing diseases.
- Ultrasound is a crucial diagnostic and monitoring tool for pediatric gallstones.
- While complications are infrequent, timely diagnosis and appropriate management, including medical dissolution, are important.
Abstract:
Authors analyse the data of 48 children with cholelithiasis (29 girls, 19 boys, mean age: 8,7 years). In the infants the gallstones developed mostly on the basis of predisposing disease and in them the spontaneous stone dissolution is frequent. Patients were divided into two groups. In the I. group gallstones developed at the presence of predisposing diseases, in the II. group such disease were not identified. In childhood more patients belong to the I. group as our results and earlier reports show, in this group characteristic symptoms cannot be found. In the II. group the vague abdominal pain was the most frequent symptom. Beyond the age of 10 years the sex ratio and the symptoms are similar to those of adults. In the I. group in 8 cases, while in the II. in 16 cases was operation done. In the latter group in two patient stone dissolution took place with Ursodeoxycholicacid. In childhood complication are infrequent. The ultrasound examination is a very useful tool in the diagnosis and follow up of these patients.