• AM Malik
  • A Khan
  • U Sheikh
  • S Sheikh
  • AA Laghari
  • KA Talpur


Background: An overall increase in the incidence of paediatric cholelithiasis forms the basis of thisstudy, which aims to investigate the overall changing clinical pattern of cholelithiasis. Methods:This is a retrospective observational descriptive study including twenty three (23) patients withgallstones admitted and operated during June 2006–June 2008 in surgical department of a teachinghospital. All the patients with sonological evidence of gallstones, less than 10 years of age withhistory of acute or chronic abdominal symptoms are included in the study population. Afteradmission all the subjects were investigated and finally operated by open approach (21 patients)during the same admission. The details of all the patients were recorded on a proforma and statisticalanalysis done on SPSS version 12. Results: Of the total study population, there were 19 (82.6 %)males and 4 (17.39%) females with a mean age of 7 years and a range of 4–10 years. Ultrasoundrevealed gallstones in all the patients with a varying proportion of the walls of gallbladder. Thecommonest presentation was abdominal pain in the right upper quadrant, which was vague, and ofmild to moderate intensity. In 21 (91.30%) patients, no specific underlying cause was found whiletwo patients (8.6%) had haematological disorder as underlying cause for the gallstones. Conclusion:This study indicates an alarming increase in the incidence of idiopathic gallstones in children lessthan 10 years of age with a distinct male predominance.Keywords: Cholelithiasis, children, idiopathic gallstones, Haematological disorders.


Palasciano G, Portincasa P, Vinciguerra V, Velardi A, Tardi

S, Baldassarre G, et al. Gallstone prevalence and gallbladder

volume in children and adolescents: An epidemiological

ultrasonographic survey and relationship to body mass index.

Am J Gastroenterol.1989;84:1278–82.

Sutton R, Chesley-Curtis S, Acute gallstone pancreatitis in

childhood. An R Coll SurgEngl, 2001;83:406–8.

Ozcanbor, Cagridinleyici E, Kebapci M, Aydogdu

SD.Ceftriaxone-associated billiary sludge and

pseudocholelithiasis during childhood. A prospective study.

Pediatr Int.2004;46:322–4.

Russo EM, Lusenti A. Cholelithiasis in pediatric age: three

cases. Pediatr Med Chir, 1999;21(1):29–31.

Ruibal Francisco J, Aleo Lujan E, Alvarez Mingote A, Pinero

Martinez E, Gomez Casares R.Childhood cholelithiasis.

Analysis of 24 patients diagnosed in our department and

review of 123 cases published in Spain. An Esp Pediatr.


Cozcolluela Cabrejas MR, Sanz Salanova LA, MartinezBerganza Asensio MT, Gomez Herrero H, Mellado Santos

JM, Miranda Orella L et al. Childhood cholelithiasis in a

district hospital. An Pediatr (Barc). 2007;66(6):611–4.

Bailey PV, Connors RH, Tracy TF Jr, Sotelo-Avila C, Lewis

JE, Weber TR. Changing spectrum of cholelithiasis and

cholecystitis in infants and children Am J Surg. Am J Surg.


Lugo-Vincente HL. Trends in management of gallbladder

disorders in children. Pediatr Surg int.1997;12:348–52.

Greenberg M, Kangarloo H, Cochran ST, Sample WF. The

ultrasonographic diagnosis of cholecystitis and cholelithiasis

in children. Radiology 1980;137:45–9.

Friesen CA, Roberts CC. Cholelithiasis: Clinical

characteristics in children. Clin Pediatr 1989;7:294–8.

Kelly DA. Liver complications of pediatric parenteral

nutrition-epidimiology.Nutrition 1998;14:153–7.

Herek O, Sarioglu A, Kocer N, Tiryaki A, Akkemic B.

Billiary pseudolithiasis in childhood: a case report. Eur J

Pediatr Surg, 1999;9:337–8.

Ceran C, Oztoprak I, Cankorkmaz L, Gumus c, Yildiz T,

Koylouglu G. Ceftriaxone-associated billiary

pseudolithiasisin paediatric surgical patients. Int. J.

Antmicrobial Agents 2005;25:256–9.

Sutton R, Cheslyn–Curtis S. Acute gallstone pancreatitis in

childhood. Ann R Coll Surg Engl, 2001;83:406–8.

Kumar R, Nguyen K, Shun A. Gallstones and common bile

duct calculi in infancy and child hood. ANZ J Surg


Miltenburg DM, Scheffer R, Breslin T, Brandt ML.

Changing indications for pediatric cholecystectomy.

Pediatrics 2000;105(6):1250–3.

Henschke CI, Teele RL. Cholelithiasis in children: recent

observations. J Ultrasound Med.1983;2(11):481–4.

Harris P, Chateau B, Miquel JF, Zavala A, Montes P,

Herrera JM et al. Cholelithiasis in children: a clinical and

morphological study. Rev Med Chil 2003;131(1):37–45.

Molander ML, Bergdahl S. Gallbladder disease, primary

cholelithiasis, or gallbladder hydrops. A review of 32

children. Pediatr Surge Intn, 2004;7(5):328–31.

Perez NA, Roiz Gomes MJ, Gonzalez FN, Nicolau CJ.

Gallstones in children. Report of one case and review of the

literature. An Esp Pediatr.1976;9(6):602–11.

Holcomb GW Jr, Holcomb GW. Cholelithiasis in infants,

children, and adolescents: Pediatr Rev, 1990;11(9):268–74.

Bruch SW, Ein SH, Rocchi C, Kim PC. The management of

non-pigmented gallstones in children. J Pediatr Surg


Wesdorp j, Bosman D, de Graaff A, Aronson D, Van der Blij

F, Taminau J. Clinical presentations and predisposing factors

of cholelithiasis and sludge in children. J Pediatr

Gastroenterol Nutr 2000;31(4):411–7.

Ganschow R. Cholelithiasis in pediatric organ transplantation

.Detection and management. Pediatr Transplantation,


Schweizer P, Lenz MP, Kirschner HJ. Pathogenesis and

symptomatology of cholelithiasis in childhood. A prospective

study. Dig Surg 2000;17(5):459–67.

Roslyn JJ, Berquist WE, Pitt HA, Mann LL, Kangarloo H,

DenBesten L, Ament ME. Increased risk of gallstones in

children receiving total parenteral nutrition. Pediatrics


Herzog D, Bouchard G. High rate of complicated idiopathic

gallstone disease in pediatric patients of a North American

tertiary care center. World J Gastroenterol 2008;14(10):1544-8.

Volker K, Martin W, Dorothee T, Lydia KA, Martin HM,

Hermann M, Wolfgang K. Prevalence of Gallbladder Stone

Disease in Obese Children and Adolescents: Influence of the

Degree of Obesity, Sex, and Pubertal Development. J Pediatr

Gastroenterol & Nutrition 2006;42(1):66–70.

Reif S, Solven DG, Lebenthal E. Gallstones in children:

Charecterization by age, etiology and outcome. Am J Dis

Children, 1991;145:105–8.

Yogi Y, Tsuchimochi A, Kikuchi J, Take H, Setoguchi T. A

pediatric case with gallstones treated with laparoscope. Dig

Endosc 1998;10:244–7.

Saleem MI, Al-Hashmi AM, Meshref SS. Mini laparoscopic

cholecystectomy in children under 10 years of age with sickle

cell disease. ANZ J Surg 2005;75:562–5.