[Why do children rarely have gallstones? Examinations of the lithoindices and the bile acid pattern in infants and children in health and disease (author's transl)].
Cholesterol gallstones occur 600-1000 times more frequent in adults than in children. Seeking a possibility to explain this discrepancy, the molar concentrations of cholesterol, lecithin and bile acids as well as the bile acid pattern have been determined in duodenal juice, after an injection of 2 U/kg pancreocymin, of 33 children aged between 4 months and 14 years who were gastroenterologically healthy. The absolute values as well as the percentage composition were calculated. The lithoindices have been determined to be Li1=0.54 +/- 0.25 and Li2=1.06 +/- 0.50 according to the formulas of Thomas and Hofmann. Dependence on age in infancy and during childhood could be excluded. The main reason for the fact that hardly any gallstones occur among children, compared to the occurrence in adults seems to be the small concentration of cholesterol in the bile. Whereas there had been no deviations either of lithoindices or in the bile acid pattern in 10 patients with coeliac disease, 2 out of 6 children with mucoviscidosis and 3 out of 4 children with small bowel syndrome showed apparently increased lithoindices. Only in the last group a bile acid pattern was found which could reduce the higher risk of getting cholelithiasis.
D000293:Adolescent; D000367:Age Factors; D001647:Bile Acids and Salts / Q000032:analysis; D002446:Celiac Disease / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D002766:Cholecystokinin; D002769:Cholelithiasis / Q000453:epidemiology*; D002784:Cholesterol / Q000032:analysis; D003550:Cystic Fibrosis / Q000175:diagnosis; D005860:Germany, West; D006801:Humans; D007223:Infant; D007419:Intestinal Secretions / Q000032:analysis*; D007421:Intestine, Small / Q000601:surgery; D010713:Phosphatidylcholines / Q000032:analysis
D001647:Bile Acids and Salts; D010713:Phosphatidylcholines; D002766:Cholecystokinin; D002784:Cholesterol
Warum haben Kinder relativ selten Gallensteine? Untersuchungen der Lithoindices und des Gallensäurenmusters bei gesunden sowie kranken Süglingen und Kindern.