Gallbladder disease in children with Down syndrome

ABSTRACT

Although gallbladder stones are known to be rare in childhood, a number of reports documented an increased prevalence of cholelithiasis and other gallbladder abnormalities in pediatrics patients with Down syndrome [DS]. The aim of our study was to find the frequency of gall bladder stones in children with DS and to investigate whether they have hypomotility of the gallbladder by ultrasonographically determined gallbladder volume and contraction index. The study included 20 children with DS diagnosed clinically and by cytogenetic analysis [study group] and 8 healthy children [control group]. Gallbladder diameters [length, width, and height], volumes and contraction index were measured in both groups by ultrasonography before and 30 minutes after a test meal. Fasting serum triglyceride and cholesterol levels were also determined. The median gallbladder fasting volume and contraction index were significantly lower in patients with DS compared to the control group. The median triglyceride level of the study group was higher than controls but the difference was statistically insignificant. Three patients with DS [15%] had asymptomatic gallbladder stones compared to none in the control group. In conclusion, incidence of gallbladder stones in DS children is high. Hypomotility of gallbladder [as evidenced by the lower contraction index] in DS could be considered a factor contributing to the high prevalence of gallstones in this group of patients