Microlithiasis, endoscopic ultrasound, and children: not just little gallstones in little adults

Neff, Lucas P.; Mishra, Girish; Fortunato, John E.; Laudadio, Jennifer; Petty, John K.

doi:10.1016/j.jpedsurg.2010.09.007

Cited by 19 publications

(16 citation statements)

References 21 publications

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“…[28] However, due to constraints imposed by air and fluid-filled loops of bowel lying above the pancreas, the detection of gallstones in the CBD using abdominal ultrasound has a low sensitivity (50%) in patients with acute biliary pancreatitis. [29] Given the limitations of abdominal ultrasound, algorithms that incorporate risk factors, biomarkers, and diagnostic imaging may assist in the swift and accurate diagnosis of acute biliary pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Associated With Biliary Pancreatitis in Children

Michael

Bai²,

Park³

et al. 2012

J. pediatr. gastroenterol. nutr.

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Little is known about risk factors for biliary pancreatitis in children. Objectives We characterized cases of pediatric biliary pancreatitis, compared biliary with non-biliary cases, examined differences in presentation between younger and older children, and studied features distinguishing gallstone- from sludge-induced pancreatitis. Methods We evaluated 76 episodes of biliary pancreatitis from 271 cases of acute pancreatitis in children admitted to a tertiary care hospital from 1994 to 2007. Results Of the 76 cases, 55% had gallstones, 21% had sludge, and 24% had structural defects. Hispanic children had a 2.85 (p=0.01) and 5.59 (p=0.003) higher probability for biliary pancreatitis than white and black children, respectively. Median serum amylase and lipase in children with biliary pancreatitis were 64% and 49% higher, respectively, compared to other etiologies (p<0.05). In multiple logistic regression, aspartate aminotransferase (AST) was an independent predictor of biliary pancreatitis (OR=6.69, p=0.001). When comparing gallstone- with sludge-induced etiologies, obesity was an independent predictor (38% more prevalent, p<0.01) of gallstone cases. Conclusions Hispanic ethnicity is a risk factor and AST is a biomarker for biliary pancreatitis over other etiologies. Furthermore, obesity can distinguish gallstone- from sludge-induced pancreatitis. These findings may spur prospective studies to determine the optimal evaluation and management of children with biliary pancreatitis.

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Section: Discussionmentioning

confidence: 99%

Risk Factors Associated With Biliary Pancreatitis in Children

Michael

Bai²,

Park³

et al. 2012

J. pediatr. gastroenterol. nutr.

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“…Biliary symptoms with no stones detected on conventional abdominal USG may benefit from endoscopic USG. 11 Natural history of GS in children is not well documented.…”

Section: Discussionmentioning

confidence: 99%

Safety of laparoscopic cholecystectomy in children using conventional instruments in a general teaching hospital by general surgeons: 14 years review

Maharjan

Shah

Gurung

et al. 2017

J. Soc. Surg. Nepal

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Introduction: There is limited specialist facility and lack of data on gallstone and laparoscopic cholecystectomy (LC) in children locally and in the region. With one government children hospital in Nepal, specialist service is far from adequate. Utilizing existing facilities to provide service is the need. We analyzed 14 years data to look in to the safety of LC in children provided by general surgeons in a general teaching hospital with conventional LC instruments used for adults. Methods: This descriptive review included children up to 14 y of age who had cholecystectomy during 14 y period from 2002 to 2015. Data on sex, age; clinical and ultrasonography findings; risk factors for gallstone; types of surgeries; bile duct injury, would infection and in-hospital mortality were analyzed. Results: There were 61 children, 0.8% of total 7469 cholecystectomy during 14 years study period. Average age was 9 years and females were 56 (84%). Out of 58-attempted LC, 56 were completed successfully. All children had history of right upper quadrant pain. Two presented with acute calculous cholecystitis. We did not find associated risk factors for stones. There was no bile duct injury. One wound infection occurred in LC converted to open. In-hospital mortality was nil. Conclusion: Cholelithiasis and cholecystectomy in children was low at 0.8% of total. With 3.4% conversion, no bile duct injury, no hospital mortality LC was safely provided by general surgeon in a general hospital using conventional facility.

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“…Rare cases of recurrent abdominal pain due to microlithiasis have been reported in children. 54 In this case, diagnostic EUS can be performed first, followed by a onesession ERCP procedure to remove the biliary stone.…”

Section: Choledocholithiasismentioning

confidence: 99%

Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound in children

Tagawa

Morita

Imagawa

et al. 2021

Digestive Endoscopy

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Gastrointestinal endoscopy is fundamental to diagnostic and therapeutic procedures in pediatric gastroenterology. In the decades since endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) for hepatobiliary and pancreatic disease were introduced into clinical practice, there has been increasing interest in these procedures, and practice guidelines and position papers that clearly define the role of ERCP and EUS in children have been published. Based on the distinction of endoscopy between children and adults, this review focuses on the current state of ERCP and EUS procedures in children, including the types of endoscopes used in children, general anesthesia and radiation exposure, biliary and pancreatic indications, considerations of education and training for ERCP and EUS procedures in children, and expectations for development of endoscopes for children.

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Microlithiasis, endoscopic ultrasound, and children: not just little gallstones in little adults

Cited by 19 publications

References 21 publications

Risk Factors Associated With Biliary Pancreatitis in Children

Risk Factors Associated With Biliary Pancreatitis in Children

Safety of laparoscopic cholecystectomy in children using conventional instruments in a general teaching hospital by general surgeons: 14 years review

Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound in children

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