Cholecystitis in Children

Francisco J. Cervantes , M.D.

December 7th 2010

Doctors Hospital of Laredo

Laredo Pediatrics and Neonatology clinic

• 11 cases between 2009-2010

• Age at presentation 11 years -18years. The Mean age is 14.3 years

• 6Male and 5 Female

• BMI 98-99++, Only 2 were 95-96

presentation

• Asymptomatic 6 cases ( patient were presented with other symptom or check up)

• Abdominal pain 5 cases. One of this category was presented to ER and other admitted to the Hospital with abdominal pain.

• Note: In Asymptomatic patients Over weight and elevated liver enzymes were the main factors for further study.

Diagnosis

• BMI

• LFT, Chemistry, Lipid profile.

• Imaging mainly ultrasound.

Ultrasound Fatty liver +Normal GB

F L + GB Sludge

F L + Chronic Cholecystitis

Cholecystitis,Cholelithiasis

3 5 1 2

Cholecystectomy

• 5 patients underwent Cholecystectomy.

1. 3 patients indication for surgery (GB sludge)

2. 2 Patients Indication ( Cholelithiasis).

• 2 patients had Diagnostic Liver biopsy which confirmed FL. But no fibrosis

SlugdeBiliary sludge is a mixture of particulate matter

and mucous that forms in bile. The composition of biliary sludge varies.

The most common particulate matter in biliarysludge is cholesterol crystals and calcium salts.

Occasionally drugs may comprise the particulate matter since bile is one of the major

routes for excretion of drugs. Biliary sludge has been associated with certain

conditions including rapid weight loss, pregnancy, medications (ceftriaxone,

octreotide), and bone marrow or solid organ transplantation.

Cholecystitis and cholelithiasis in Children

It been recognized with increase frequency in infancy, childhood and adolescence.

Hematological disorders account for large proportion of the cases; However, most

cases the etiology uncertain

Causes of GB disease in Children

History of abdominal surgery Prolonged parenteral nutrition Hemolytic disease Hepatobiliary disease Obesity and trauma Acute renal failure Prolonged fasting Low calorie diet Certain medications