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Background: Gallstones are generallyuncommon in infants and children. Formation of gallstone is a very poorlyunderstood phenomenon. In general, the risk factors for cholithiasis in infantsinclude patients who are ill, are receiving hyperalimentation, are premature,have congenital anomalies and have necrotizing enterocolitis. Children aged 1 -5 years most frequently have hemolysis as the underlying condition1. Materials and Methods: From Jan 2012 to Feb 2014, a studyentitled -A Prospective Study of Cholelithiasis in Children- was conducted inPostgraduate Department of General Surgery Govt. Medical College Srinagar. Thepatients selected for the study were in the age group of 1 to 14 years ofeither sex. There were a total of 141 cases, out of which only 38 hadultrasound documented gallstones. All the patients included in the study wereevaluated for prevalence, clinical presentation, and pathological features ofgallstones, and were analysed for metabolic causes of gallstones. Results: Theprevalence of chliothiasis in symptomatic patients was found to be 26.95%higher than the prevalence of gallstones in children in other parts of world,also the mean age of presentation was 9.3 years ranging from 6 - 14 years. Maleto female ratio was 3:2 and male predominance was found in all age groupscontrary to female predominance in adults. Most common presenting symptom wasright upper quadrant pain followed by vomiting and nausea similar topresentation of symptomatic gallstones in adults. 4 patients had a positivefamily history of cholithiasis in the first degree relatives; 25 65.7%patients had no underlying risk factor for gallstones contrary to presumptionthat gallstones in children are mostly secondary to some hematological disorderor other predisposing factors. Chronic cholecystities was found in 81% ofpatients with gallstones and composition of gallstones retrieved was differentfrom those of adult gallstones with calcium carbonate gallstones relativelycommon in children but composition of black and brown stones was almost similarto adult stones. Conclusion: Gallstone disease was increasingly gainingrecognition in peadiatic practice due to significant documented increase innon-heamolytic cases over the last two decades. The observed gallstones prevalence,clinical presentation, pathological features of gallstones, and analysedmetabolic causes of gallstones in children are different from those stonesfound in adults. The results of our study demonstrated that gallstones andgallstone related complications in peadiatic populations were different fromthe adult gallstone disease and there was an increase in prevalence ofgallstones in children with no under lying risk factor for gallstones, andsurgery remained the corne stone of treatment for peadiatric cholithiasis as inadults.

KEYWORDS

Peadiatric Cholelithiasis, Symptomatic Cholelithiasis, Peadiatric Age Group, Gallbladder Stones

Cite this paper

Ahmad, R. , Nafae, A. , Bashir, S. , Salam, P. , Khan, Q. , Suhail, M. , Mushtaq, U. and Ahmad, J. 2015 A Prospective Study of Cholilithiasis in Children. Surgical Science, 6, 149-156. doi: 10.4236-ss.2015.63024.





Author: Raiees Ahmad*, Alfer Nafae, Shahnawaz Bashir, Pervaze Salam, Qayoom Khan, Malik Suhail, Umer Mushtaq, Javid Ahmad

Source: http://www.scirp.org/



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