Posted By HFHSM.D.-bb on January 30, 1998 at 13:45:13:
In Reply to: Re: Re: pediatric gallstones posted by Jeffrey Tapia on January 25, 1998 at 23:30:14:
: : My 4 year old son has a 7mm gallstone in the gallbladder. I am looking for information on pediatric gallstones: causes, treatments in young children. How do young children respond to gallbladder removal?
: Dear Jeffrey Tapia ,
: Gallstones are being identified in infants and children in increasing numbers. There are reports of gallstones being identified in unborn infants during routine maternal ultrasound prior to delivery. In addition, gallstones have been identified in infants shortly after birth. The reason for such early development of gallstones is not known.
: Gallstones can result from a variety of birth defects of red blood cells that cause these cells to break down prematurely (This premature destruction of red cells is called hemolytic anemia). The hemoglobin of these cells is converted to a compound called bilirubin. Accumulation of bilirubin in the gallbladder can lead to stone formation, under certain conditions. Gallstones can also be found in cystic fibrosis. Finally, gallstones can occur in low birth weight premature infants who require prolonged hospitalization, intensive supportive care, and multiple medications.
: When the gallstone is identified, a decision must be made regarding treatment. If the child has documented inflammation of the gallbladder or pancreas (presents as severe abdominal pain) or if the gallstone is in the common bile duct (the tube leading from the liver to the intestine), surgery is required. Usually, surgery involves removing the gallbladder and the gallstone. In some cases, the gallstone is removed from the common bile duct by a procedure known as endoscopy.
: Because the child with gallstones carries a lifetime risk of the problems described in the above paragraph, surgery is also recommended for children with mild abdominal pains or abnormal liver tests that can not be explained by other conditions.
: The surgical treatment has changed substantially during the last few years. Laparoscopic or minimally invasive surgery is done frequently in children. The surgical scar is small and the time spent in the hospital is very brief. Children generally tolerate surgery better than adults and rarely experience complications following the procedure.
: As you can see, upon completion of a proper evaluation, an informed decision regarding surgery can be made. I assume from your letter that you are already seeing a physician. If you are in the Detroit area and wish further consultation please call (313) 876-2088 and request consultation with Dr. Belknap, one of our experts in the diagnosis and treatment of liver diseases in children and infants.
: This response is offered for your general information and should not replace the conclusions drawn from a careful and complete evaluation by a physician.
: keywords: gallstones, children, laparoscopic surgery, hemolytic anemia
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