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Gallstone disease in children

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Abstract

Context

Little is known about the epidemiology of cholelithiasis in children. Cholelithiasis and choledocholithiasis were considered to be uncommon in infants and children but have been increasingly diagnosed in recent years due to widespread use of ultrasonography. However, there is not much of information from India and no consensus among Indian pediatricians and pediatric surgeons regarding management of gallstones in children. Hence, the purpose of this review is to increase awareness about the management of gallstones in children.

Methods

Extensive electronic (PubMed) literature search was made for this purpose and literature (original articles, clinical trials, case series, review articles) related to gallstones in children were reviewed.

Conclusions

The etiologies of cholelithiasis are hemolytic (20%–30%), other known etiology (40%–50%) such as total parenteral nutrition, ileal disease, congenital biliary diseases, and idiopathic (30–40 %). Spontaneous resolution of gallstones is frequent in infants and hence a period of observation is recommended even for choledocholithiasis. Children with gallstones can present with typical biliary symptoms (50%), nonspecific symptoms (25%), be asymptomatic (20%) or complicated (5%–10%). Cholecystectomy is useful in children with typical biliary symptoms but is not recommended in those with non-specific symptoms. Prophylactic cholecystectomy is recommended in children with hemolytic disorders.

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Authors and Affiliations

  1. Department of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, Uttar Pradesh, India

    Ujjal Poddar

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Poddar, U. Gallstone disease in children. Indian Pediatr 47, 945–953 (2010). https://doi.org/10.1007/s13312-010-0159-2

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