[Childhood cholelithiasis in a district hospital]. / Colelitiasis en la infancia en un Hospital de Area.

Cholelithiasis is a rare finding in children, even though recent series show increased detection of this disease. A retrospective study was performed in children with a diagnosis of cholelithiasis between 1993 and 2005 in the Reina Sofia Hospital in Tudela (Spain). Eighteen patients with cholelithiasis and three with biliary sludge were detected. Predisposing factors for cholelithiasis were prematurity and parenteral nutrition (one patient), sepsis (two patients), obesity (one patient), and a family history of the disease (one patient). The disease was idiopathic in 11 patients. Gallstones were detected in two patients presenting with appendicular symptoms. One child with biliary sludge had received treatment with ceftriaxone as a predisposing factor. All patients were diagnosed by ultrasound. Plain abdominal X-ray detected lithiasis in 12 of the 15 patients (80 %) with cholelithiasis who underwent this procedure. The most frequent symptoms were abdominal pain (seven patients), abdominal pain and vomiting (five patients), and diarrhea (one patient). Two patients presented with appendicular symptoms. Fourteen patients underwent surgery (open cholecystectomy in two and laparoscopic cholecystectomy in 12). None of the patients required emergency surgery. Cholelithiasis in children is an unusual finding, but is not exceptional and is associated with nonspecific symptoms. Plain abdominal X-ray is useful in diagnosis but the main diagnostic technique is ultrasonography.

Colelitiasis en la infancia en un Hospital de Área / Childhood cholelithiasis in a district hospital

Aunque la colelitiasis es un hallazgo infrecuente en niños, series recientes muestran un aumento en la frecuencia de detección de la misma. En el Hospital Reina Sofía de Tudela, se ha efectuado un estudio retrospectivo en niños diagnosticados de colelitiasis entre los años 1993 y 2005. Se detectaron 18 casos de colelitiasis y 3 casos de barro biliar. Entre los factores predisponentes de colelitiasis en este estudio encontramos prematuridad y nutrición parenteral (1), sepsis (2), obesidad (1), historia familiar de colelitiasis (1) e idiopáticos (11). A 2 pacientes que acudieron al hospital con clínica apendicular, se les detectaron litiasis biliares. Un individuo con barro biliar presentó como antecedente el tratamiento con ceftriaxona. La totalidad de pacientes fueron diagnosticados mediante ecografía, y en 12 de los 15 casos de colelitiasis en los que se disponía de radiografía simple, se detectaron las litiasis mediante esta técnica (80 % de los casos). Respecto a la clínica, los síntomas más frecuentes fueron dolor abdominal (7 casos), dolor abdominal y vómitos (5 casos), diarrea (1 caso). Dos pacientes acudieron con clínica apendicular. De los 18 niños diagnosticados de colelitiasis, en 2 casos se practicó colecistectomía mediante laparotomía y a 12 individuos se les efectuó colecistectomía por vía laparoscópica. Ninguno precisó tratamiento quirúrgico urgente. La litiasis biliar en la infancia es un hallazgo infrecuente pero no excepcional, que presenta frecuentemente sintomatología inespecífica. La radiología convencional es útil en la valoración de estos pacientes, pero la ecografía es la técnica idónea para detectar colelitiasis

Cholelithiasis is a rare finding in children, even though recent series show increased detection of this disease. A retrospective study was performed in children with a diagnosis of cholelithiasis between 1993 and 2005 in the Reina Sofia Hospital in Tudela (Spain). Eighteen patients with cholelithiasis and three with biliary sludge were detected. Predisposing factors for cholelithiasis were prematurity and parenteral nutrition (one patient), sepsis (two patients), obesity (one patient), and a family history of the disease (one patient). The disease was idiopathic in 11 patients. Gallstones were detected in two patients presenting with appendicular symptoms. One child with biliary sludge had received treatment with ceftriaxone as a predisposing factor. All patients were diagnosed by ultrasound. Plain abdominal X-ray detected lithiasis in 12 of the 15 patients (80 %) with cholelithiasis who underwent this procedure. The most frequent symptoms were abdominal pain (seven patients), abdominal pain and vomiting (five patients), and diarrhea (one patient). Two patients presented with appendicular symptoms. Fourteen patients underwent surgery (open cholecystectomy in two and laparoscopic cholecystectomy in 12). None of the patients required emergency surgery. Cholelithiasis in children is an unusual finding, but is not exceptional and is associated with nonspecific symptoms. Plain abdominal X-ray is useful in diagnosis but the main diagnostic technique is ultrasonography