Cholelithiasis in children 16 years and below in Basrah: Epidemiological and Clinical study


Background: Although compared with adults, cholelithiasis )or gallstone disease( is unusual in infants, and in children but it is certainly not rare. Gallstones currently are being recognized in children with increased frequency therefore, it should be studied more carefully in our locality as it represents a significant health problem. Method: This is a retrospective hospital based study of children with gall stones aged 16 years and below who were admitted to the surgical wards of five major hospitals in Basrah city, during the period from first of January 2007 to 30th June 2012. Then children were studied for demographic criteria, past history, clinical presentation, hospitalization, and the treatment approach. Results: The total number of the study population included in this study was 95children, the mean age of them was 11.7± 3.6 years (Range: 9 months - 16 years) and the male to female ratio was (1:1.4). The majority of the patients 46 patients (78%) were symptomatic at the time of diagnosis, while only 13 patients (22%) were asymptomatic, and the reported symptoms were: abdominal pain, fever, nausea, vomiting, and jaundice. Sickle cell disease (SCD), Thalassemia major and hereditary Spherocytosis were three major types of hemolytic disease that predisposed children to gallstones.Conclusions: Sickle cell disease was the major predisposing factor and responsible for 59.3% of gall stone in this study, while Thalassemia and hereditary Spherocytosis were reported less frequently (6.8% and 1.7% respectively). No reported risk factor was seen in 32.2%. Surgery was performed for most of the patients; types of surgical approach were either open cholecystectomy (with or without splenectomy) or laparoscopic cholecystectomy.