Cholelithiasis in children, a clinical, hematological and pathological study including chemical analysis of gallstones
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 4
Abstract
Background: Gallstone disease which has long been considered as an adult disease, is increasingly gaining recognition in the pediatric practice because of the significant documented increase in non-hemolytic cases over the last two decades.AimThe aim of this study was to evaluate the childhood cholelithiasis and its clinical,haematological, pathological aspects and the management. Methods: The present prospective study was conducted in the Department of Paediatric Surgery, SKIMS, Srinagar over a period of two years. In this study 44 patients in age group of 2-14 years were included with ultrasound proved cholelithiasis.These patients were reviewed for demographic information, predisposing factors, presenting symptoms, laboratory findings, complications, treatment, stone analysis and histopatholigical characteristic of specimen. Results: In our study of 44 patients,the mean age was 9.4years with 21 males and 23 females.Most common symptom was pain abdomen. In our study, 10 patients (22.7%) had history of intestinal ascariasis, 11 patient (2.3%) had history of TPN(3days), 4 patients (9.1%) had history of meconium ileus, 8 patients(18.2%) had history of ceftriaxone therapy (3-6 days) and 3 patients (6.8%) had positive family history of cholelithiasis in the first degree relatives. 4 patients (9.1%) had hemolytic disorder and rest of the patients had (47.7%) no risk factor or predilection for developing gallstones. 9 patients (20.5%) had single calculi in the gallbladder, 31 patients (70.5%) had multiple calculi and 4 patients (9.1%) had multiple calculi with splenomegaly. 38 patients (86.3%) had stone size <5mm while the rest of patients (13.7%) had stone size >5mm. The gall bladder specimen onhistopathological examination showed chronic cholecystitis in 40 patients (93.0%), congested gall bladder in 1 patient (2.3%) and fibrotic inflamed gallbladder in 2 patients (4.7%).Stone analysis showed cholesterol stones in 25 patients (58.1%), pigmented stones in 13 patients (30.2%), mixed stones in 2 patients (4.7%) and 3 patients (7%) had calcium carbonate stones. Conclusion: In childrencholelithiasis is not uncommon and around two cases of cholelithiasis are admitted in pediatric surgery per 100 cases of total admission in our institution. The most common cause for cholelithiasis in children is idiopathic. Cholesterol stones are the most common stones in children with cholelithiasis followed by pigmented stone.Chroniccholecystitis is the most common histopathological findings in children with cholelithiasis.Cholecystectomy with open or laparoscope is safe and effective for cholelithiasis in children.
Authors and Affiliations
Dr Mushtaq Ahmad Bhat, Dr Bashir Ahmad Bhat, Dr Yaqoob Hassan, Dr Anayatullah, Dr Irshad Ahmad
Keywords
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- EP ID EP573176
- DOI 10.9790/0853-1804088490.
- Views 82
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