title: Choledocholithiasis in African American and Hispanic patients: a comparison between painless presentation and classical biliary pain with regards to clinical manifestations and outcomes.
abstract: Choledocholithiasis (CDL) usually presents with biliary pain. Painless CDL is also known to occur, especially in the elderly. The purpose of this study is to determine whether the mode of presentation (painful vs. painless) influences the clinical course and outcomes of CDL in African American and Hispanic patients. Ten years of admission and discharge records (January 1998-December 2007) were reviewed retrospectively, yielding 527 community hospital patients, aged 23-97 years, with the final diagnosis of CDL. Patients with painless presentation had higher odds of having comorbidities compared to patients presenting with pain. However, patients who presented with biliary pain were predominantly younger (mean age 34 years), and 59% were Hispanic females (p = 0.001). In our study painless CDL was associated with higher morbidity and mortality.
authors.affiliation: Martin Luther King Jr. Multi-Service Ambulatory Care Center, Charles Drew University of Medicine and Science, 12021 South Wilmington Avenue, Los Angeles, CA, 90059, USA, abbasiakhtar@cdrewu.edu.
authors.forename: Abbasi J
authors.initials: AJ
authors.lastname: Akhtar
authors.forename: Aslam A
authors.initials: AA
authors.lastname: Akhtar
authors.forename: Manmeet S
authors.initials: MS
authors.lastname: Padda
mesh_terms: D015746:Abdominal Pain / Q000208:ethnology / Q000503:physiopathology; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001659:Biliary Tract / Q000503:physiopathology; D002140:California; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D002763:Cholecystectomy / Q000379:methods / Q000706:statistics & numerical data; D042883:Choledocholithiasis / Q000175:diagnosis* / Q000208:ethnology* / Q000628:therapy; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010147:Pain Measurement; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome; D014505:Urban Population; D055815:Young Adult
chemical_list: D005765:Gastrointestinal Agents