The ultrasonographic diagnosis of cholecystitis and cholelithiasis in children.

Greenberg, Mark; Kangarloo, Hooshang; Cochran, Sachiko T.; Sample, W. Frederick

doi:10.1148/radiology.137.3.7444057

Cited by 38 publications

(15 citation statements)

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“…Acoustic shadowing was not re¬ quired for sonographic diagnosis because it is not always present when the foci are small. 10 Roentgenographic diagnosis of gallstones re¬ quired calcifications in the right upper quad¬ rant to be present in more than one view.…”

Section: Methodsmentioning

confidence: 99%

Gallstones in Children

Reif

Sloven²,

Lebenthal³

1991

Am J Dis Child

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Section: Methodsmentioning

confidence: 99%

Gallstones in Children

Reif

Sloven²,

Lebenthal³

1991

Am J Dis Child

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“…A lthough reports of gallbladder disease are common, few published reports detail the sonographic appearance of normal gallbladders in children. [1][2][3][4][5][6][7] Because of this lack of information, it is often difficult to determine whether a child's gallbladder is diseased. In neonates, a small gallbladder may be the result of biliary atresia, and a condition such as Kawasaki disease can lead to gallbladder enlargement accompanied by hydrops.…”

mentioning

confidence: 99%

Sonographic measurements of normal gallbladder sizes in children

Yoo

Kwak

Lee

et al. 2003

J of Clinical Ultrasound

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“…The youngest age of cholecystectomy was 3 years in one of the Australian females, who also had a diagnosis of Down syndrome. 17 The remainder of individuals in the ARSD cohort were 18,20,22,22,24,25,29,30, and 31 years old. A similar pattern was noted in the InterRett cohort, with four individuals younger than 18 years (4,12,15,17), with the remaining (n=10) aged 18 to 47 years.…”

Section: Part 1: Occurrence Of Gallbladder Diseasementioning

confidence: 99%

“…The recommendations of the expert panel of clinicians are shown in Table III In summary, screaming and apparent abdominal pain were considered suggestive of gallbladder disease, often in association with fever and vomiting. 24,25 After excluding gastro-oesophageal reflux as the source of pain, 26 the panel recommended diagnostic tests including ultrasound to examine for gallstones and a hepatobiliary iminodiacetic acid scan to examine the rate at which bile is ejected from the gallbladder. 25,27 There was no consensus in favour of or against use of ursodeoxycholic acid to dissolve gallstones in RTT.…”

Section: Part 3: Assessment and Management Guidelinesmentioning

confidence: 99%

“…24,25 After excluding gastro-oesophageal reflux as the source of pain, 26 the panel recommended diagnostic tests including ultrasound to examine for gallstones and a hepatobiliary iminodiacetic acid scan to examine the rate at which bile is ejected from the gallbladder. 25,27 There was no consensus in favour of or against use of ursodeoxycholic acid to dissolve gallstones in RTT. In addition to appropriate analgesia, cholecystectomy was recommended for symptomatic biliary dyskinesia, cholelithiasis and in all symptomatic patients with calcified stones, 24,28,29 but not for those with cholecystitis or when asymptomatic (Table III).…”

Section: Part 3: Assessment and Management Guidelinesmentioning

confidence: 99%

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Prevalence, clinical investigation, and management of gallbladder disease in Rett syndrome

Freilinger

Böhm

Lanator

et al. 2014

Develop Med Child Neuro

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AIM This study determined the prevalence of cholelithiasis and/or cholecystectomy in Rett syndrome, described gallbladder function in a clinical cohort, and identified recommendations for assessment and management of gallbladder disease.METHOD The incidence of cholelithiasis/cholecystectomy was estimated from data describing 270 and 681 individuals with a pathogenic MECP2 mutation in the Australian Rett Syndrome Database and the International Rett Syndrome Phenotype Database respectively. Gallbladder function in 25 females (mean age 16y 5mo, SD 20y 7mo, range 3y 5mo-47y 10mo) with Rett syndrome (RTT) was evaluated with clinical assessment and ultrasound of the gallbladder. The Delphi technique was used to develop assessment and treatment recommendations. RESULTSThe incidence rate for cholelithiasis and/or cholecystectomy was 2.3 (95% confidence interval [CI] 1.1-4.2) and 1.8 (95% CI 1.0-3.0) per 1000 person-years in the Australian and International Databases respectively. The mean contractility index of the gallbladder for the clinical sample was 46.5% (SD 38.3%), smaller than for healthy individuals but similar to children with Down syndrome, despite no clinical symptoms. After excluding gastroesophageal reflux, gallbladder disease should be considered as a cause of abdominal pain in RTT and cholecystectomy recommended if symptomatic.INTERPRETATION Gallbladder disease is relatively common in RTT and should be considered in the differential diagnosis of abdominal pain in RTT.Rett syndrome (RTT) is a severe neurodevelopmental disorder caused by mutations in the X-linked methylCpG-binding-protein-2 (MECP2) gene.1 After a period of apparently normal early development, there is a period of regression including loss of purposeful hand use and/or language skills, and the development of distinctive hand stereotypies and impaired gait. There are also supportive criteria including poor growth, respiratory irregularities, and the development of scoliosis.2 Many factors contribute to poor growth in RTT including altered oropharyngeal dysfunction and reduced food intake, 3,4 and problems with gastroesophageal motility such as reflux and constipation. 5Dysmotility may result from absent primary or secondary intestinal waves and the presence of tertiary intestinal waves as observed during videofluoroscopy, with concurrent delayed gastric emptying and atony.3 In a recent questionnaire-based survey in the USA (n=983), feeding problems were reported in 81% and gastrointestinal problems in 92% of individuals with Rett syndrome. 6 Gastrointestinal dysfunction in RTT contributes to clinical severity and affects the daily lives of the females and their caregivers. 6In general, gallstones are rare in childhood and adolescence, with estimated prevalence between 0% and 2% in the small number of studies undertaken. [7][8][9][10][11][12] However, there appears to be a higher prevalence in particular populations of children, such as those with Down syndrome, with reported prevalences up to 25%. 13,14 Clinical studies in Down syndrome indi...

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The ultrasonographic diagnosis of cholecystitis and cholelithiasis in children.

Cited by 38 publications

References 0 publications

Gallstones in Children

Gallstones in Children

Sonographic measurements of normal gallbladder sizes in children

Prevalence, clinical investigation, and management of gallbladder disease in Rett syndrome

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