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Cuhaci Cakir B.,Well Child Clinic Ankara Child Health and Diseases Hematology Oncology Research and Training Hospital Ankara Turkey
Journal of Paediatrics and Child Health | Year: 2016

Aim: The aim of this study was to evaluate the clinical presentation, risk factors, complications, treatment and outcomes of cholelithiasis in children. Methods: Children with cholelithiasis were reviewed for demographic information, predisposing factors, presenting symptoms, laboratory findings, complications, treatment and outcome, retrospectively. Results: A total of 254 children with cholelithiasis (mean age: 8.9±5.2years) were recruited to the study. Girls (52.8%) were significantly older than boys (P<0.001). Symptomatic patients (59%) were significantly older than asymptomatic patients (P=0.002). Abdominal pain was the most frequent symptom. No risk factors were identified in 56.6% of the patients. Ceftriaxone (20%) was the most commonly associated risk factor. At presentation, at least one of the following complications was seen in 14.1% of patients: cholecystitis (10.9%), obstructive jaundice (2.7%), pancreatitis (1.96%) and cholangitis (1.2%). There was no relationship between gallstone size and symptoms, aetiological factors and complications. The cholelithiasis dissolution rate was higher in younger children (P=0.032), in those with biliary sludge (P<0.0001) and ceftriaxone-related cholelithiasis (P<0.001). Haemolytic anaemia (P=0.001) and older age (P=0.002) were associated with stable stones. Ursodeoxycholic acid was administered to 94.4% of patients at presentation. Twenty-nine patients underwent cholecystectomy, and seven patients underwent endoscopic retrograde cholangiopancreotography. Patients who were symptomatic at presentation had significantly more frequent symptoms at follow-up (P<0.001) Conclusions: Dissolution rate of cholelithiasis was higher in younger children, biliary sludge formation and ceftriaxone-related cholelithiasis but lower in older children and haemolytic anaemia-related cholelithiasis. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

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