Biliary dyskinesia in pediatrics
Biliary dyskinesia is a potential cause for acalculous biliary colic in pediatric patients. A triad of symptoms and signs, consisting of abdominal pain (with or without associated nausea or fatty food intolerance), absence of gallstones, and an abnormally low cholecystokinin-stimulated gallbladder ejection fraction is used to diagnose the disorder. In several small pediatric case series, cholecystectomy resulted in symptomatic improvement in a majority of patients with biliary dyskinesia. However, the diagnosis of biliary dyskinesia and appropriate management remain controversial. This review discusses the purported pathophysiology of biliary dyskinesia and the data available regarding diagnosis and treatment of this entity in the pediatric population.
Unable to display preview. Download preview PDF.
References and Recommended Reading
- 1.Campbell BT, Narasimhan NP, Golladay ES, Hirschl RB: Biliary dyskinesia: a potentially unrecognized cause of abdominal pain in children. Pediatr Surg Int 2004, 20:579–581. Most recent descriptive case series on effects of cholecystectomy in children with biliary dyskinesia.PubMedCrossRefGoogle Scholar
- 3.Wood J, Holland A, Shun A, Martin H: Biliary dyskinesia: Is the problem with Oddi? Pediatr Surg Int 2004, 20:83–86. Small descriptive case series on effects of cholecystectomy in children with biliary dyskinesia. Discussion on reasons for therapeutic failure of cholecystectomy.PubMedCrossRefGoogle Scholar
- 8.Lonovics J, Madacsy L, Szepes Z, et al.: Humoral mechanisms and clinical aspects of biliary tract motility. Scand J Gastroenterol 1998, Suppl 228:73–89. Review of physiologic regulation of the biliary motility and pathophysiologic mechanisms of biliary dyskinesia.Google Scholar
- 9.Toouli J: Biliary tract motor dysfunction. In Baillieres Clinical Gastroenterology. Edited by Dent J. London: Bailliere Tindall; 1991: 409–430.Google Scholar
- 14.Boyle JT: Abdominal pain. In Pediatric Gastrointestinal Disease. Edited by Walker WA, Kleinman RE, Sherman PM, et al. Hamilton, ON, Canada: BC Decker; 2004: 225–243.Google Scholar