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Cholelithiasis in infancy: a study of 40 cases
D Debray1, D Pariente, F Gauthier
1Département de Pédiatrie, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.
The Journal of Pediatrics
|March 1, 1993
Summary
Infant cholelithiasis, or gallstones in infants, can cause cholestatic jaundice. Interventional radiology and spontaneous resolution are effective treatments, reserving surgery for complex cases.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Interventional Radiology
Background:
- Cholelithiasis (gallstones) in infants is uncommon but can lead to serious complications.
- Identifying predisposing factors and understanding the natural history of infant gallstones is crucial for appropriate management.
Purpose of the Study:
- To investigate the incidence, clinical presentation, diagnostic methods, and treatment outcomes of cholelithiasis in infants.
- To evaluate the efficacy of interventional radiology and conservative management for infant gallstones.
Main Methods:
- Retrospective analysis of 40 infants (<1 year) diagnosed with cholelithiasis over 17 years.
- Utilized ultrasonography, percutaneous transhepatic cholangiography (PTC), and operative cholangiography for diagnosis.
- Assessed outcomes of surgical, interventional radiologic, and conservative management, including spontaneous resolution.
Main Results:
- Common bile duct lithiasis was present in 34 infants, often presenting with cholestatic jaundice.
- Ultrasonography and cholangiography were key diagnostic tools, identifying gallstones and biliary dilation.
- Interventional radiology was successful in 12 of 15 infants; spontaneous resolution occurred in 10 infants with cholestasis.
Conclusions:
- Common bile duct lithiasis is a significant cause of cholestatic jaundice in infants.
- Percutaneous cholangiography with biliary drainage is an effective treatment, reducing the need for surgery.
- Gallstones in infants may originate from fetal or early neonatal lithogenic processes.