Skip to main content
NCBI home page
Annals of Surgery logoLink to Annals of Surgery
. 1980 May;191(5):626–635. doi: 10.1097/00000658-198005000-00015

Cholecystitis, cholelithiasis and common duct stenosis in children and adolescents.

G W Holcomb Jr, J A O'Neill Jr, G W Holcomb 3rd
PMCID: PMC1344752  PMID: 6989334

Abstract

A study of 100 patients from 14 months through 18 years of age with extrahepatic biliary tract conditions who have been treated from 1950 through 1979 is reported. For discussion, these have been classified into four groups including acalculous cholecystitis, nonhemolytic cholelithiasis, hemolytic cholelithiasis and stenosis of the common duct. Ninety-nine patients were operated on and there were no deaths. Except for unusual contraindications, cholecystectomy is preferred for acute noncalculous cholecystitis. The largest number having gallstones were those patients (87%) without hemolytic disease. Only 13% had an associated hemolytic disorder. Cholecystectomy is the preferred treatment and common duct exploration is utilized when indicated. Six children with chronic relapsing pancreatitis secondary to stenosis of the ampulla of Vater and two with common duct stenosis are analyzed. Although extrahepatic biliary disorders are usually not considered in the differential diagnosis of children and adolescents with vague abdominal pain, it is evident by this large number of patients that there should be greater emphasis placed on earlier diagnosis in the future.

Full text

PDF
626

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ariyan S., Shessel F. S., Pickett L. K. Cholecystitis and cholelithiasis masking as abdominal crises in sickle cell disease. Pediatrics. 1976 Aug;58(2):252–258. [PubMed] [Google Scholar]
  2. Azar H., Chrispin A. R., Waterston D. J. Esophageal replacement with transverse colon in infants and children. J Pediatr Surg. 1971 Feb;6(1):3–9. doi: 10.1016/0022-3468(71)90661-0. [DOI] [PubMed] [Google Scholar]
  3. BABBITT D. P. Gallstones in children; report of four cases. AMA J Dis Child. 1956 Jul;92(1):5–8. doi: 10.1001/archpedi.1956.02060030007003. [DOI] [PubMed] [Google Scholar]
  4. BARTLETT M. K., NARDI G. L. Treatment of recurrent pancreatitis by transduodenal sphincterotomy and exploration of the pancreatic duct. N Engl J Med. 1960 Mar 31;262:643–648. doi: 10.1056/NEJM196003312621302. [DOI] [PubMed] [Google Scholar]
  5. CARNEVALI J. F., REMINE W. H., DOCKERTY M. B., BOLLMAN J. L., GRINDLAY J. H. An experimental study of side-to-side pancreaticojejunostomy after ductal obstruction. Arch Surg. 1960 May;80:774–787. doi: 10.1001/archsurg.1960.01290220066010. [DOI] [PubMed] [Google Scholar]
  6. COMFORT M. W., STEINBERG A. G. Pedigree of a family with hereditary chronic relapsing pancreatitis. Gastroenterology. 1952 May;21(1):54–63. [PubMed] [Google Scholar]
  7. Cameron J. L., Capuzzi D. M., Zuidema G. D., Margolis S. Acute pancreatitis with hyperlipemia: the incidence of lipid abnormalities in acute pancreatitis. Ann Surg. 1973 Apr;177(4):483–489. doi: 10.1097/00000658-197304000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Donahoe P. K., Hendren W. H. Bile duct perforation in a newborn with stenosis of the ampulla of Vater. J Pediatr Surg. 1976 Oct;11(5):823–825. doi: 10.1016/0022-3468(76)90109-3. [DOI] [PubMed] [Google Scholar]
  9. Friedman G. D., Kannel W. B., Dawber T. R. The epidemiology of gallbladder disease: observations in the Framingham Study. J Chronic Dis. 1966 Mar;19(3):273–292. doi: 10.1016/0021-9681(66)90132-9. [DOI] [PubMed] [Google Scholar]
  10. Goodman D. B. Cholelithiasis in persons under 25 years old. Clinicopathologic review of 96 cases. JAMA. 1976 Oct 11;236(15):1731–1732. [PubMed] [Google Scholar]
  11. Graivier L., Dorman D. W., Votteler T. P. Gallbladder disease in infants and children. Surgery. 1968 Apr;63(4):690–696. [PubMed] [Google Scholar]
  12. HAGBERG B., SVENNERHOLM L., THOREN L. Cholelithiasis in childhood. A follow-up study with special reference to heredity, constitutional factors and serum lipids. Acta Chir Scand. 1962 Apr;123:307–315. [PubMed] [Google Scholar]
  13. HENDREN W. H., GREEP J. M., PATTON A. S. PANCREATITIS IN CHILDHOOD: EXPERIENCE WITH 15 CASES. Arch Dis Child. 1965 Apr;40:132–145. doi: 10.1136/adc.40.210.132. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. HOPKINS J. W., LYNN H. B., DOWER J. C. Acute noncalculous cholecystitis in a three-year-old child: report of a case diagnosed at operation. Clin Pediatr (Phila) 1962 Nov;1:105–110. doi: 10.1177/000992286200100121. [DOI] [PubMed] [Google Scholar]
  15. Harned R. K., Babbitt D. P. Cholelithiasis in children. Radiology. 1975 Nov;117(2):391–393. doi: 10.1148/117.2.391. [DOI] [PubMed] [Google Scholar]
  16. IMAMOGLU K., WANGENSTEEN S. L., ROOT H. D., SALMON P. A., GRIFFEN W. O., Jr, WANGENSTEEN O. H. Production of gallstones by prolonged administration of progesterone and estradiol in rabbits. Surg Forum. 1960;10:246–249. [PubMed] [Google Scholar]
  17. Jönsson P. E., Andersson A. Postoperative acute acalculous cholecystitis. Arch Surg. 1976 Oct;111(10):1097–1101. doi: 10.1001/archsurg.1976.01360280055008. [DOI] [PubMed] [Google Scholar]
  18. MacMillan R. W., Schullinger J. N., Santulli T. V. Cholelithiasis in childhood. Am J Surg. 1974 Jun;127(6):689–692. doi: 10.1016/0002-9610(74)90348-1. [DOI] [PubMed] [Google Scholar]
  19. Munster A. M., Goodwin M. N., Pruitt B. A., Jr Acalculous cholecystitis in burned patients. Am J Surg. 1971 Nov;122(5):591–593. doi: 10.1016/0002-9610(71)90284-4. [DOI] [PubMed] [Google Scholar]
  20. Pieretti R., Auldist A. W., Stephens C. A. Acute cholecystitis in children. Surg Gynecol Obstet. 1975 Jan;140(1):16–18. [PubMed] [Google Scholar]
  21. Robechek P. J. Hereditary chronic relapsing pancreatitis. A clue to pancreatitis in general? Am J Surg. 1967 Jun;113(6):819–824. doi: 10.1016/0002-9610(67)90354-6. [DOI] [PubMed] [Google Scholar]
  22. Robinson A. E., Erwin J. H., Wiseman H. J., Kodroff M. B. Cholecystitis and hydrops of the gallbladder in the newborn. Radiology. 1977 Mar;122(3):749–751. doi: 10.1148/122.3.749. [DOI] [PubMed] [Google Scholar]
  23. SEILER I. Gallbladder disease in children. Cases illustrating familial predisposition. AMA J Dis Child. 1960 May;99:662–666. doi: 10.1001/archpedi.1960.02070030664014. [DOI] [PubMed] [Google Scholar]
  24. SNYDER W. H., Jr, CHAFFIN L., OETTINGER L. Cholelithiasis and perforation of the gallbladder in an infant, with recovery. J Am Med Assoc. 1952 Aug 30;149(18):1645–1646. doi: 10.1001/jama.1952.72930350001009. [DOI] [PubMed] [Google Scholar]
  25. Sears H. F., Golden G. T., Horsley J. S., 3rd Cholecystitis in childhood and adolescence. Arch Surg. 1973 May;106(5):651–653. doi: 10.1001/archsurg.1973.01350170023006. [DOI] [PubMed] [Google Scholar]
  26. Simcock M. J., Forster F. M. Pregnancy is cholestatic. Med J Aust. 1967 Nov 25;2(22):971–973. doi: 10.5694/j.1326-5377.1967.tb19875.x. [DOI] [PubMed] [Google Scholar]
  27. Small D. M., Rapo S. Source of abnormal bile in patients with cholesterol gallstones. N Engl J Med. 1970 Jul 9;283(2):53–57. doi: 10.1056/NEJM197007092830201. [DOI] [PubMed] [Google Scholar]
  28. Smith R. Progress in the surgical treatment of pancreatic disease. Am J Surg. 1973 Feb;125(2):143–153. doi: 10.1016/0002-9610(73)90019-6. [DOI] [PubMed] [Google Scholar]
  29. Ternberg J. L., Keating J. P. Acute acalculous cholecystitis. Complication of other illnesses in childhood. Arch Surg. 1975 May;110(5):543–547. doi: 10.1001/archsurg.1975.01360110089016. [DOI] [PubMed] [Google Scholar]
  30. ULIN A. W., NOSAL J. L., MARTIN W. L. Cholecystitis in childhood; associated obstructive jaundice. Surgery. 1952 Feb;31(2):312–326. [PubMed] [Google Scholar]
  31. WAINWRIGHT C. W. Intrapancreatic obstruction. N Engl J Med. 1950 Feb 1;244(5):161–170. doi: 10.1056/NEJM195102012440501. [DOI] [PubMed] [Google Scholar]
  32. Williams T. E., Jr, Sherman N. J., Clatworthy H. W., Jr Chronic fibrosing pancreatitis in childhood: a cause of recurrent abdominal pain. Pediatrics. 1967 Dec;40(6):1019–1023. [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES