Gallstones in Egyptian infants and children: risk factors, complications and outcome: a single center experience

Abstract

Background: The widespread use of abdominal ultrasonography in children documented increased detection rate of gallstones. The aim of this study was to assess the possible risk factors of gallstones and to detect the complication rate and outcome of the disease in Egyptian infants and children from a hepatologist perspective. This prospective study included 35 cases, with ultrasound-detected gallstones, who presented to the Pediatric Hepatology Unit from July 2015 to October 2017. All patients were initially evaluated by full history, general and abdominal examination, laboratory assessment, and ultrasound findings to detect possible risk factors of gallstones. Management approach was individualized for each patient according to his/her condition, and the patients were followed up at 3 months interval. Results: The patients' ages ranged from 3.5 months up to 17 years. The median age of gallstone detection was 2 years. Gallstones were symptomatic in 62.9% with abdominal pain in 51.4%. Complications in the form of choledocholithiasis were detected in 7 patients (20%). Laparoscopic cholecystectomy was done for 7 patients while conservative management was applied for 24 patients. Complete resolution occurred in 8.3% and partial resolution in 33.3%. Chronic hemolytic anemia was the most commonly identified risk factor for gallstones. Patients needed surgical intervention had significant higher serum cholesterol and LDL levels (P = 0.006 and P = 0.002 respectively). Conclusion: Risk factors for gallstones could be identified in most of pediatric cases. Symptomatic presentation is common among the pediatric population. Conservative management is recommended for asymptomatic cases of gallstones in children. Laparoscopic cholecystectomy is a safe and recommended procedure for complicated and symptomatic cases of gallstones.

Cholelithiasis Associated to Acute Pancreatitis and Chronic Cholecystitis; A Case Report

“…3,4 In population based studies, the prevalence of cholelithiasis in children is about 1.9%. 3,5,6 Other study explain that this case's prevalence was 0.15-0.22 with male:female ratio are 2.3:1. Median age for boys was 5 years (3 months-14 years) and the median age for girl is 9 years (7 months-15 years).…”

“…Idiopathic cholelithiasis, with no identifiable risk factors, has been reported for 23.2% -52.5%. 5 On the other hand comorbidities that are often found in cholelithiasis patients are hepatitis (30.8%), choledocholithiasis (16.9%), cholecystitis (16.9%), and acute pancreatitis (6.2%). 12 Acute pancreatitis was found through abdominal ultrasound examination.…”

Assessment of Risk Factors and Complications of Laparoscopic Cholecystectomy

“…In present study, age group 20-40 years had 10 males and 5 females, 40-60 years had 14 males and 12 females and >60 years had 20 males and 13 females. A group researcher found that the patients' ages ranged from 3.5 months up to 17 years (Enayet et al, 2020). The median age of gallstone detection was 2 years.…”

Gall Stones in Pediatric Population

“…Unlike adults, children are likely to be symptomatic, the prevalence of symptomatic children is from 50-70% [44]. The most common clinical presentation is right upper quadrant abdominal pain [usually after meals] which may be radiating to the right shoulder, nausea, vomiting and occasionally fever.…”