RESUMO
To estimate the information content of different methods of diagnosing biliary diseases, 103 children aged 5 to 15 years, including 25 practically healthy children as control, were examined. Abdominal organs, particularly the liver and gallbladder were examined by echography. The duodenal contents was explored by microscopy of the sediment and biochemistry which included analysis in the vesicular and liver portions of the concentrations of phospholipids, activity of phospholipases A and C as well as measurements of creatine kinase, lactate dehydrogenase, alkaline phosphatase, C-reactive protein and of the diphenylamine index. Ultrasonography was found to be highly informative. The characteristic echographic alterations seen in dyskinesia of the biliary tract, dyscholias and chronic cholecystitis were defined. For differential diagnosis of dyscholia and chronic cholecystitis it is necessary to carry out biochemistry of the duodenal contents including measurements of phospholipids, activity of phospholipases A and C, alkaline phosphatase, creatine kinase, lactate dehydrogenase, C-reactive protein and the diphenylamine index. Based on the similarity of the alterations seen in children with different cholepathies, a concept is advanced of the mechanisms by which functional and organic diseases of the gallbladder are formed.
