Clinico‐pathological spectrum of gallbladder disease in children

Punia, Rajpal Singh; Garg, Shailja; Bisht, Bhumika; Dalal, Usha; Mohan, Harsh

doi:10.1111/j.1651-2227.2010.01876.x

Cited by 23 publications

(25 citation statements)

References 16 publications

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“…Boys and girls are equally affected in early childhood, but as in adults, most previous studies reported a female predominance in pediatric gallbladder disease starting from puberty (6,(16)(17)(18). In the study by Wesdrop et al (6), a female predominance was noted only after the age of 14 years.…”

Section: Discussionmentioning

confidence: 60%

A retrospective review of children with gallstone: Single-center experience from Central Anatolia

Gökçe

Yıldırım²,

Erdoğan³

2014

Turk J Gastroenterol

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Background/Aims: To evaluate children with gallstone in respect to demographic features, type of presentation, predisposing risk factors, laboratory features, complications, and outcome. Materials and Methods: Overall, 124 children with sonographically diagnosed gallstone were stratified into group 1 (symptomatic) and group 2 (asymptomatic). The data on demographic features, predisposing risk factors, laboratory features, complications, and outcome were collected from medical charts and compared by using convenient statistical methods.Results: There were 76 (61%) children in group 1. Females were significantly older than males at the time of diagnosis (p=0.001). After adjusting for age and sex, asymptomatic presentation was associated with hemolytic anemia (r=346, <0.001) and being an oncologic patient (r=248, p=0.006). No risk factor was specifically associated with having a symptomatic presentation. Sixteen children (12.9%) developed complications: 14 (18.4%) in group 1 and 2 (4.2%) in group 2 (p=0.027). Gallstone resolution was detected in 20 (29.4%) and 10 children (23.3%) in groups 1 and 2, respectively (p=0.477). Resolution was observed in 43.8% of children with ceftriaxone-associated gallstone. The rate of resolution with ursodeoxycholic acid (UDCA) was similar to that observed with expectant management. Gallstone resolution was evident in 9 infants (50.0%) and was significantly higher than children over 2 years of age (21 out of 106 children, 19.8%) (p=0.006). The most important factor associated with gallstone resolution was to be an infant (<2 years of age) at the time of diagnosis (OR: 3.1; 95% CI: 1.1-8.8; p=0.034). Conclusion: Ceftriaxone-associated gallstones are most likely to resolve but do not always undergo spontaneous resolution. UDCA treatment seems to be ineffective. Young age is a favorable factor for gallstone resolution. The rate of complications in children with asymptomatic presentation is considerably low. Thus, clinical follow-up rather than surgical intervention is suggested in children with asymptomatic presentation and in infants.

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Section: Discussionmentioning

confidence: 60%

A retrospective review of children with gallstone: Single-center experience from Central Anatolia

Gökçe

Yıldırım²,

Erdoğan³

2014

Turk J Gastroenterol

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“…Although both genders are equally affected in early childhood, most previous studies have demonstrated a female predominance in pediatric gallbladder disease, starting from puberty. In fact, most cases of cholelithiasis at young age are diagnosed in the second decade of life (1,(6)(7)(8).…”

Section: Contextmentioning

confidence: 99%

Cholelithiasis in Children: A Diagnostic and Therapeutic Approach

Kadı¹,

Kianifar²,

Karami³

2016

J Pediatr Rev

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Context: Although cholelithiasis is not a common condition in children, recent studies have documented an increasing incidence rate, owing to the development of diagnostic tools. The prevalence of cholelithiasis in children has been reported to be 0.13% -0.3%, whereas in obese children and adolescents, the prevalence rate has been estimated at 2% -6.1%. In this study, we aimed to review cholelithiasis in children. The gathered results could be useful in finding a suitable method and proper clinical practice for this complication.Evidence Acquisition: For literature review, international databases, including PubMed and Google Scholar, were searched, using keyword combinations, e.g., "cholelithiasis in children", "gallstone in children", and "childhood cholelithiasis", to review diagnostic and therapeutic approaches for cholelithiasis in children from 2006 to 2016. Also, some articles were retrieved through hand searching and reviewing the reference lists of papers, regardless of the date of publication. Abstracts, duplicates, and articles irrelevant to childhood cholelithiasis were excluded.Results: A total of 36 out of 93 articles were reviewed. The results showed that the prevalence of childhood cholelithiasis varies in different communities, with a global rate of 1.9%. Most cases of cholelithiasis in children were associated with underlying diseases. Hemolytic diseases, hereditary blood disorders, and cirrhosis were among the main causes of cholelithiasis in children. Cholelithiasis was detected incidentally or via diagnostic evaluations due to the presentation of symptoms. Conclusions:Although evaluation of the underlying causes of gallstone formation and appropriate diagnostic/therapeutic implications is still a challenging issue in the management of childhood cholelithiasis, in asymptomatic cases or those with gallstones of certain sizes, it is only recommended to monitor the disease or rule out the underlying causes. It should be noted that long periods of diagnostic and therapeutic approaches can impose stress and tension on families.

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“…In children with cholecystitis, AAC accounts for up to 21.4 % of cases [ 47 ]. AAC is commonly associated with an infectious disease; however, it may be seen in previously healthy children as well.…”

Section: Acalculous Cholecystitismentioning

confidence: 99%