title: A retrospective review of children with gallstone: single-center experience from Central Anatolia.
abstract: OBJECTIVE
  To evaluate children with gallstone in respect to demographic features, type of presentation, predisposing risk factors, laboratory features, complications, and outcome.
  
  
  METHODS
  Overall, 124 children with sonographically diagnosed gallstone were stratified into group 1 (symptomatic) and group 2 (asymptomatic). The data on demographic features, predisposing risk factors, laboratory features, complications, and outcome were collected from medical charts and compared by using convenient statistical methods.
  
  
  RESULTS
  There were 76 (61%) children in group 1. Females were significantly older than males at the time of diagnosis (p=0.001). After adjusting for age and sex, asymptomatic presentation was associated with hemolytic anemia (r=346, <0.001) and being an oncologic patient (r=248, p=0.006). No risk factor was specifically associated with having a symptomatic presentation. Sixteen children (12.9%) developed complications: 14 (18.4%) in group 1 and 2 (4.2%) in group 2 (p=0.027). Gallstone resolution was detected in 20 (29.4%) and 10 children (23.3%) in groups 1 and 2, respectively (p=0.477). Resolution was observed in 43.8% of children with ceftriaxone-associated gallstone. The rate of resolution with ursodeoxycholic acid (UDCA) was similar to that observed with expectant management. Gallstone resolution was evident in 9 infants (50.0%) and was significantly higher than children over 2 years of age (21 out of 106 children, 19.8%) (p=0.006). The most important factor associated with gallstone resolution was to be an infant (<2 years of age) at the time of diagnosis (OR: 3.1; 95% CI: 1.1-8.8; p=0.034).
  
  
  CONCLUSIONS
  Ceftriaxone-associated gallstones are most likely to resolve but do not always undergo spontaneous resolution. UDCA treatment seems to be ineffective. Young age is a favorable factor for gallstone resolution. The rate of complications in children with asymptomatic presentation is considerably low. Thus, clinical follow-up rather than surgical intervention is suggested in children with asymptomatic presentation and in infants.
authors.affiliation: Department of Pediatric Gastroenterology, Hepatology and Nutrition, Bezmiâlem Vakif University Faculty of Medicine, İstanbul, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Gökçe
authors.forename: Miraç
authors.initials: M
authors.lastname: Yıldırım
authors.forename: Derya
authors.initials: D
authors.lastname: Erdoğan
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002756:Cholagogues and Choleretics / Q000627:therapeutic use; D002763:Cholecystectomy; D005260:Female; D042882:Gallstones / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014421:Turkey; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use; D057832:Watchful Waiting
chemical_list: D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid