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J Paediatr Child Health. 2016 Oct;52(10):944-949. doi: 10.1111/jpc.13235. Epub 2016 May 28.

Risk factors, complications and outcome of cholelithiasis in children: A retrospective, single-centre review.

Author information

1
Department of Pediatric Gastroenterology, Ankara Child Health and Diseases Hematology-Oncology Research and Training Hospital, Ankara, Turkey. ceytun@yahoo.com.
2
Well Child Clinic, Ankara Child Health and Diseases Hematology-Oncology Research and Training Hospital, Ankara, Turkey.
3
Department of Radiology, Ankara Child Health and Diseases Hematology-Oncology Research and Training Hospital, Ankara, Turkey.
4
Department of Pediatric Surgery, Ankara Child Health and Diseases Hematology-Oncology Research and Training Hospital, Ankara, Turkey.
5
Department of Pediatric Hematology, Ankara Child Health and Diseases Hematology-Oncology Research and Training Hospital, Ankara, Turkey.

Abstract

AIM:

The aim of this study was to evaluate the clinical presentation, risk factors, complications, treatment and outcomes of cholelithiasis in children.

METHODS:

Children with cholelithiasis were reviewed for demographic information, predisposing factors, presenting symptoms, laboratory findings, complications, treatment and outcome, retrospectively.

RESULTS:

A total of 254 children with cholelithiasis (mean age: 8.9 ± 5.2 years) were recruited to the study. Girls (52.8%) were significantly older than boys (P < 0.001). Symptomatic patients (59%) were significantly older than asymptomatic patients (P = 0.002). Abdominal pain was the most frequent symptom. No risk factors were identified in 56.6% of the patients. Ceftriaxone (20%) was the most commonly associated risk factor. At presentation, at least one of the following complications was seen in 14.1% of patients: cholecystitis (10.9%), obstructive jaundice (2.7%), pancreatitis (1.96%) and cholangitis (1.2%). There was no relationship between gallstone size and symptoms, aetiological factors and complications. The cholelithiasis dissolution rate was higher in younger children (P = 0.032), in those with biliary sludge (P < 0.0001) and ceftriaxone-related cholelithiasis (P < 0.001). Haemolytic anaemia (P = 0.001) and older age (P = 0.002) were associated with stable stones. Ursodeoxycholic acid was administered to 94.4% of patients at presentation. Twenty-nine patients underwent cholecystectomy, and seven patients underwent endoscopic retrograde cholangiopancreotography. Patients who were symptomatic at presentation had significantly more frequent symptoms at follow-up (P < 0.001) CONCLUSIONS: Dissolution rate of cholelithiasis was higher in younger children, biliary sludge formation and ceftriaxone-related cholelithiasis but lower in older children and haemolytic anaemia-related cholelithiasis.

KEYWORDS:

aetiology; children; cholelithiasis; treatment

PMID:
27236017
DOI:
10.1111/jpc.13235
[Indexed for MEDLINE]

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