Gallstones in childhood: Retrospective analysis of 60 cases

Abstract

Aim: The purpose of this study was to documentation of the characteristics of children with cholelithiasis by means of age, sex, clinical manifestations and risk factors. Material and Method: Sixty cases (aged 0-18 years) with ultrasonographic evidence of cholelithiasis were enrolled in the study. Results: Mean age of the patients was 7.8 +/- 5.1 years (range: 0.25-18 years), 38 (63.3%) of them were females. Underlying risk factors were identified in 34 (56.7%) of cases (15 ceftriaxone use, six hemolytic diseases, five Down's syndrome, four obesity, two total parenteral nutrition and sepsis, one inflammatory disease and one chronic cholestatic liver disease). No etiology could be found in 26 (43.3%) patients who were defined as idiopathic. Of 46 patients who were followed at least for three months, eight (17.4%) had cholecystectomy, 16 (34.8%) showed differences in stone size and the stones were resolved in 24 patients (52.2%). When the cases related to ceftriaxone use were excluded, the percentage of the disappaerance of the stones was found to be 28.3%. Ursodeoxycolic acid was effective on resolution of symptoms in 69.2% of patients. The complications of gallstones were recorded in five (8.3%) patients. Conclusions: Cholelithiasis is more common in children than previously thought. The most common risk factors are ceftriaxone use and hemolytic diseases but about half of the cases are still idiopathic. There is a need for close monitoring of patients in especially risk groups because of gallstone development and its complications. (Turk Arch Ped 2010; 45: 119-23)