Gallstones in children. Characterization by age, etiology, and outcome
S. Reif, D. G. Sloven and E. Lebenthal
Division of Gastroenterology and Nutrition, Children's Hospital of Buffalo, NY.
Fifty children and adolescents were found to have gallstones at Children's
Hospital of Buffalo (NY) during a period of 10 years. The mean (+/- SD) age
was 12.2 +/- 6.2 years, with 21 boys and 29 girls. The majority of patients
could be categorized into four groups: hemolytic disease (18 patients),
parenteral nutrition (eight patients), adolescent pregnancy (seven
patients), and idiopathic (10 patients), while seven patients had a variety
of other etiologies. Right upper quadrant pain was the most common symptom
(32 patients), followed by jaundice (15 patients), vomiting (13 patients),
and nonspecific abdominal complaints (13 patients). Ten patients presented
with jaundice and underlying hemolytic disease; seven patients were
asymptomatic. Clinical presentation was found to vary with age and factors
associated with the development of gallstones. Ultrasonography was the mode
of diagnosis in 48 patients. Cholecystectomy was performed in 36 patients.
In contrast to gallstones in adults, after exclusion of the patients with
adolescent pregnancy, there was no female predominance. Pancreatitis was
the most common complication, occurring in 8% of the patients;
cholecystitis and cholangitis were absent.
