Characterization by Age, Etiology, and Outcome

\s=b\Fifty children and adolescents were found to have gallstones at Children's Hospital of Buffalo (NY) during a period of 10 years. The mean (\m=+-\SD)age was 12.2 \m=+-\6.2 years, with 21 boys and 29 girls. The majority of patients could be catego- rized into four groups: hemolytic disease (18 patients), parenteral nutrition (eight patients), adolescent pregnancy (seven patients), and idiopathic (10 patients), while seven patients had a variety of other etiologies. Right upper quadrant pain was the most common symptom (32 patients), followed by jaundice (15 patients), vomit- immunodeficiency,8 and parenteral nu¬ trition.9 In this study, we discuss all patients having gallstones diagnosed at Children's Hospital of Buffalo (NY) from 1979 to 1989 to determine the clini¬ cal presentation, method of diagnosis, and modality of treatment in regard to the different age groups and factors as¬ sociated with the development of gallstones. PATIENTS AND METHODS All charts of inpatients and outpatients with gallstones diagnosed radiographically or surgically at Children's Hospital of Buffalo from 1979 to 1989 were reviewed. Sonogra- phic diagnosis of gallstones was based on the presence of mobile echogenic foci in the gall¬ bladder lumen or in the region ofthe gallblad¬ der fossa. Acoustic shadowing was not re¬ quired for sonographic diagnosis because it is not always present when the foci are small.10 Roentgenographic diagnosis of gallstones re¬ quired calcifications in the right upper quad¬ rant to be present in more than one view. Patients with previous biliary tract surgery, acalculus cholecystitis, and biliary tract dis¬ ease without proven gallstones were exclud¬ ed from our study. Fifty patients met the criteria ofthe study. Patients were characterized by age, associ¬ ated conditions, clinical presentation, labora¬ tory studies, method of diagnosis, therapy, and outcome. A univariate analysis was con¬ ducted looking for a correlation between age, race, sex, clinical presentation, laboratory studies, therapy, and factors associated with gallstones by 2 analysis. RESULTS