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Infant cholelithiasis: report of a case
Surgery Today
|January 1, 1997
Summary
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.
