Herzog Denise, Bouchard Guylaine
Division of Gastroenterology and Nutrition, Saint Justine Hospital, 3175, Cote Sainte-Catherine, Montreal, Quebec, Canada.
World J Gastroenterol. 2008 Mar 14;14(10):1544-8. doi: 10.3748/wjg.14.1544.
To assess spectrum and etiology of gallstones and biliary sludge in the pediatric population of a North American tertiary care centre.
Retrospective review of abdominal ultrasounds recorded at Saint Justine Hospital over a period of 24 mo (8/2003 to 8/2005) in patients < 19 years of age. Patients < 2 years of age were analyzed separately.
The presence of gallstones was noted in 127 patients. In 107 it was a new diagnosis, in 48/105 (45.7%) patients > 2 years of age idiopathic gallstone disease was found. These 48 patients represent 2.1% of the population who required ultrasound for abdominal pain. Complicated gallstone disease occurred in 28/48 with idiopathic disease, mainly adolescent girls. Patients with hemolytic disorders, cystic fibrosis, oncologic diseases or kidney transplantation and gallstones were asymptomatic and stones were detected during routine abdominal ultrasound. Twenty two patients < 2 years of age not consulting for abdominal pain had gallstone disease of diverse etiology. Biliary sludge was seen in 84 patients, 78.5% on total parenteral nutrition. In 4 patients, sludge progressed to gallstones.
Idiopathic gallstone disease and its rate of complication are more frequent in our cohort than expected from previous studies. Adolescent girls with abdominal pain and idiopathic gallstones require special attention for complicated disease course.
评估北美一家三级医疗中心儿科人群胆结石和胆泥的谱及病因。
回顾性分析圣朱斯汀医院在24个月期间（2003年8月至2005年8月）记录的19岁以下患者的腹部超声检查结果。2岁以下患者单独分析。
127例患者发现有胆结石。其中107例为新诊断病例，在105例2岁以上患者中，48例（45.7%）发现特发性胆结石病。这48例患者占因腹痛接受超声检查人群的2.1%。28例特发性疾病患者出现复杂性胆结石病，主要为青春期女孩。患有溶血性疾病、囊性纤维化、肿瘤性疾病或肾移植且有胆结石的患者无症状，结石在常规腹部超声检查时被发现。22例2岁以下未因腹痛就诊的患者患有病因各异的胆结石病。84例患者可见胆泥，78.5%接受全胃肠外营养。4例患者胆泥进展为胆结石。
在我们的队列中，特发性胆结石病及其并发症发生率比以往研究预期的更常见。有腹痛及特发性胆结石的青春期女孩需要特别关注其复杂的病程。
