[Cholelithiasis in childhood. Proposals based on a multicentric study].
Fifty six cases of cholelithiasis in patients aged two months to 15 years (mean age 7.65 years) concerning to 11 hospitals are reviewed. The study protocol followed was the same in all medical records, although own criterions were considered on management performed in each center. From the cases, it follows: 1. Male/female rate is 1/1.5. 2. Symptomatology in infancy is relatively poor and pain localization is not orientative. 3. It was an incidentally finding in 41 per 100 of the cases. 4. Ultrasonography is the best examination procedure rendering diagnosis in the 51 cases it was underwent. 5. Hematologic study was abnormal in six of 46 cases. 6. Medical treatment was not performed in any hospital. 7. Existence of "lithogenic families" seems to be demonstrated. 8. The presence of four patients with Down syndrome in this series must be pointed out. 9. Among total 56 cases, 21 underwent surgical treatment, 29 were conservatively treated, two have died and four patients had spontaneous stone resolution. 10. In the face of these, we propose: A) Surgical treatment in symptomatic cases, porcelain gallbladder and nonfunctionating gallbladder. B) Expectant management and sonographic monitoring in asymptomatic cases. C) Carefully evaluation in patients with predisposing factors and patients with recurrent abdominal pain.
Elías Pollina
J
J
Servicio de Cirugía Pediátrica, Hospital Miguel Servet, Zaragoza.
Garate
J
J
Martin Bejarano
E
E
Vitoria
J C
JC
Sojo
A
A
Ubalde
J
J
Perez Marrodan
J A
JA
Olivera
J E
JE
Zubillaga
P
P
Fernandez
P
P
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002769:Cholelithiasis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male
Colelitiasis en la infancia. Propuestas de un estudio multicéntrico.