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A Prospective Study of Cholilithiasis in Children

DOI: 10.4236/ss.2015.63024, PP. 149-156

Keywords: Peadiatric Cholelithiasis, Symptomatic Cholelithiasis, Peadiatric Age Group, Gallbladder Stones

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Abstract:

Background: Gallstones are generally uncommon in infants and children. Formation of gallstone is a very poorly understood phenomenon. In general, the risk factors for cholithiasis in infants include patients who are ill, are receiving hyperalimentation, are premature, have congenital anomalies and have necrotizing enterocolitis. Children aged 1 - 5 years most frequently have hemolysis as the underlying condition [1]. Materials and Methods: From Jan 2012 to Feb 2014, a study entitled “A Prospective Study of Cholelithiasis in Children” was conducted in Postgraduate Department of General Surgery Govt. Medical College Srinagar. The patients selected for the study were in the age group of 1 to 14 years of either sex. There were a total of 141 cases, out of which only 38 had ultrasound documented gallstones. All the patients included in the study were evaluated for prevalence, clinical presentation, and pathological features of gallstones, and were analysed for metabolic causes of gallstones. Results: The prevalence of chliothiasis in symptomatic patients was found to be 26.95% higher than the prevalence of gallstones in children in other parts of world, also the mean age of presentation was 9.3 years ranging from 6 - 14 years. Male to female ratio was 3:2 and male predominance was found in all age groups contrary to female predominance in adults. Most common presenting symptom was right upper quadrant pain followed by vomiting and nausea similar to presentation of symptomatic gallstones in adults. 4 patients had a positive family history of cholithiasis in the first degree relatives; 25 (65.7%) patients had no underlying risk factor for gallstones contrary to presumption that gallstones in children are mostly secondary to some hematological disorder or other predisposing factors. Chronic cholecystities was found in 81% of patients with gallstones and composition of gallstones retrieved was different from those of adult gallstones with calcium carbonate gallstones relatively common in children but composition of black and brown stones was almost similar to adult stones. Conclusion: Gallstone disease was increasingly gaining recognition in peadiatic practice due to significant documented increase in non-heamolytic cases

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