Infant cholelithiasis: report of a case

K Asabe1, N Handa

  • 1Department of Pediatric Surgery, Oita Prefectural Hospital, Japan.

Surgery Today
|January 1, 1997
PubMed

Insights

Infantile cholelithiasis (gallstones in infants) is rare, often linked to predisposing factors. Diagnosis is increasingly aided by non-invasive ultrasonography, highlighting the need for awareness in pediatric obstructive jaundice.

Area of Science:

  • Pediatric Gastroenterology
  • Neonatal Surgery
  • Medical Imaging

Background:

  • Cholelithiasis (gallstones) is exceptionally rare in infants, posing diagnostic challenges.
  • VACTER association is a complex congenital anomaly that can present with gastrointestinal and other issues.
  • Obstructive jaundice and acholic stool in neonates warrant thorough investigation for biliary pathology.

Observation:

  • A 2-month-old male infant with VACTER association presented with persistent obstructive jaundice and acholic stool.
  • Review of Japanese literature identified 30infantile cholelithiasis cases, with 28 having predisposing factors.
  • Gallstones were located in the gallbladder (18 cases), bile ducts (7 cases), or both (3 cases).

Findings:

  • Ten cases of radiopaque gallstones were valuable for plain abdominal roentgenogram diagnosis.
  • Nine infants underwent surgical intervention, including cholecystectomy, choledocholithotomy, and cholecystolithotomy.
  • Ultrasonography is increasingly utilized for non-invasive and accurate diagnosis of infantile cholelithiasis.

Implications:

  • Increased reporting suggests a potential rise in infantile cholelithiasis diagnoses.
  • Early diagnosis and appropriate management are crucial for infants presenting with obstructive jaundice.
  • Ultrasonography offers a safe and effective method for identifying gallstones in the neonatal population.