Gallstones in Children

Reif, Shimon; Sloven, Daniel G.; Lebenthal, Emanuel

doi:10.1001/archpedi.1991.02160010111028

Cited by 77 publications

(27 citation statements)

References 22 publications

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“…In addition, 20 children who have been followed up in our clinic since they were born and who have shown predisposing diseases were under a long-term observation and were operated after symptomatic gallstones were diagnosed. However, in the current literature [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35]there is even no report without selection of patients. Therefore, the published data in the literature are also not representative.…”

Section: Discussionmentioning

confidence: 99%

“…Most of the data in the literature [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35]dealing with the pathogenesis and symptomatology of gallstones in childhood refer to a relatively small number of cases, are mostly reviewed in retrospective and the patients are often not divided into different age groups. Further studies have to be based on larger patient series, the patients must be divided into age groups, the composition of bile and stones and the morphological alterations of the bile ducts have to be taken into consideration.…”

Section: Introductionmentioning

confidence: 99%

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Pathogenesis and Symptomatology of Cholelithiasis in Childhood

Schweizer

Lenz

Kirschner³

2000

Dig Surg

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Questions: How may gallstones develop if there is no hemolytic disorder and no malformation or alteration of the gallbladder and cystic ducts? Was there a change in the incidence of stones and the assignment of the patients to different age groups? The literature gives answers to these questions on the basis of only few cases. Therefore, a relatively large prospective database of collected cases during 30 years shall be used to give additional answers. Methods: The data are derived from 111 children with symptomatic gallstones without hemolytic diseases. 109 of them required operative therapy. They were examined preoperatively and postoperatively maximum during 30 years of follow-up as well according to a defined program. This program includes taking the patient’s history, evaluation of clinical, radiological including sonographical examination, exclusion of hemolytic primary diseases, histological investigation of intraoperatively gained specimens of the gallbladder, and the spectroscopic qualitative as well as semiquantitative analysis of stones and bile. Results: (1) The qualitative and quantitative composition of the stones is different in the four age groups. (2) The causes of lithogenesis are different in the four age groups. (3) Children with long-term TPN, after cardiopulmonary bypass operations, after extended small bowel resection, suffering from obesity, and girls using hormonal contraception are at risk of developing gallstones. We recommend to observe these patients by repeated ultrasound controls for gallstone formation during a minimum of 10 years. (4) Malformations and pathological alterations of the gallbladder are rare causes for increased lithogenity. The gallbladder appeared morphologically normal in 61% of patients with symptomatic gallstones. (5) An increased frequency of gallstones during the last 30 years was only observed in the age group under 1 year.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pathogenesis and Symptomatology of Cholelithiasis in Childhood

Schweizer

Lenz

Kirschner³

2000

Dig Surg

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“…Most commonly, children with cholelithiasis present with typical right upper quadrant pain (50%) or nonspecific abdominal symptoms (25%) including poorly localized abdominal pain and nausea. Around 20% of cases are asymptomatic (incidentally detected stones) (11,46,47). Gallstones in children are more often (60%) symptomatic than in adults (20%) (46).…”

Section: Cholelithiasis In Childrenmentioning

confidence: 99%

“…Around 20% of cases are asymptomatic (incidentally detected stones) (11,46,47). Gallstones in children are more often (60%) symptomatic than in adults (20%) (46). The type of symptoms depend on the age of presentation, older children (6 years or more) often localize pain in the right upper quadrant whereas younger children (5 years or less) tend to present with nonspecific symptoms (11).…”

Section: Cholelithiasis In Childrenmentioning

confidence: 99%

Gallstone disease in children

Poddar

2010

Indian Pediatr

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the etiologies of cholelithiasis are hemolytic (20% -30%), other known etiology (40%-50%) such as total parenteral nutrition, ileal disease, congenital biliary diseases, and idiopathic (30-40 %). Spontaneous resolution of gallstones is frequent in infants and hence a period of observation is recommended even for choledocholithiasis. Children with gallstones can present with typical biliary symptoms (50%), nonspecific symptoms (25%), be asymptomatic (20%) or complicated (5% -10%). Cholecystectomy is useful in children with typical biliary symptoms but is not recommended in those with non-specific symptoms. Prophylactic cholecystectomy is recommended in children with hemolytic disorders.

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“…[21] The findings of this study regarding ultrasound scanning were consistent with results of other studies. [5,22,23] This may be explained by that most of gallstones remain asymptomatic until complications develop. In this study 88.1% were treated surgically which is a definitive treatment of gallstones.…”

Section: Discussionmentioning

confidence: 99%

Cholelithiasis in children 16 years and below in Basrah: Epidemiological and Clinical study

Hassan¹,

Al-Asadi²,

Alhasani³

2015

MJBU

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Background: Although compared with adults, cholelithiasis)or gallstone disease(is unusual in infants, and in children but it is certainly not rare. Gallstones currently are being recognized in children with increased frequency therefore, it should be studied more carefully in our locality as it represents a significant health problem. Method: This is a retrospective hospital based study of children with gall stones aged 16 years and below who were admitted to the surgical wards of five major hospitals in Basrah city, during the period from first of January 2007 to 30 th June 2012. Then children were studied for demographic criteria, past history, clinical presentation, hospitalization, and the treatment approach. Results: The total number of the study population included in this study was 95children, the mean age of them was 11.7± 3.6 years (Range: 9 months-16 years) and the male to female ratio was (1:1.4). The majority of the patients 46 patients (78%) were symptomatic at the time of diagnosis, while only 13 patients (22%) were asymptomatic, and the reported symptoms were: abdominal pain, fever, nausea, vomiting, and jaundice. Sickle cell disease (SCD), Thalassemia major and hereditary Spherocytosis were three major types of hemolytic disease that predisposed children to gallstones. Conclusions: Sickle cell disease was the major predisposing factor and responsible for 59.3% of gall stone in this study, while Thalassemia and hereditary Spherocytosis were reported less frequently (6.8% and 1.7% respectively). No reported risk factor was seen in 32.2%. Surgery was performed for most of the patients; types of surgical approach were either open cholecystectomy (with or without splenectomy) or laparoscopic cholecystectomy.

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Gallstones in Children

Cited by 77 publications

References 22 publications

Pathogenesis and Symptomatology of Cholelithiasis in Childhood

Pathogenesis and Symptomatology of Cholelithiasis in Childhood

Gallstone disease in children

Cholelithiasis in children 16 years and below in Basrah: Epidemiological and Clinical study

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