Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: The widespread use of abdominal ultrasonography in children documented increased detection rate of gallstones. Many etiological factors have been associated with gallstones in children where hemolytic diseases are considered the most common cause. Aim of work: To assess the possible risk factors of gallstones and to detect the complication rate and outcome of the disease in Egyptian infants and children from a hepatologist perspective. Patients and methods: The study included all cases below 18 years of age of both sexes with ultrasound detected gallstones who presented to pediatric Hepatology Unit, Cairo University Children{u2019}s Hospital, Cairo, Egypt during the time period from July 2015 to October 2017. All Patients were initially evaluated by full history, general and abdominal examination, laboratory assessment andultrasound findings. Management approach was individualized for each patient according to his condition and the patients were followed up for a period of at least 3 months. Results: The study included 35 patients with median age of onset 2 years. Gallstones were symptomatic in 62.9% with abdominal pain in 51.4%. Complications in the form of choledocholithiasis were detected in 7 patients (20%). Laparoscopic cholecystectomy was done for 7 patientswhile conservative management was performed for 24 patients with a median follow up period of 14 months. Complete resolution occurred in 8.3% and partial resolution in 33.3%. Conclusion: Because of low complication rate and resolution of some cases of gallstones, conservative management is recommended for asymptomatic cases. Resolution is better among infantile cases. Laparoscopic cholecystectomy is a safe and recommended procedure for complicated and symptomatic cases of gallstones

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