Cholelithiasis in Children: A Diagnostic and Therapeutic Approach

Context: Although cholelithiasis is not a common condition in children, recent studies have documented an increasing incidence rate, owing to the development of diagnostic tools. The prevalence of cholelithiasis in children has been reported to be 0.13% - 0.3%, whereas in obese children and adolescents, the prevalence rate has been estimated at 2% - 6.1%. In this study, we aimed to review cholelithiasis in children. The gathered results could be useful in finding a suitable method and proper clinical practice for this complication.
Evidence Acquisition: For literature review, international databases, including PubMed and Google Scholar, were searched, using keyword combinations, e.g., “cholelithiasis in children”, “gallstone in children”, and “childhood cholelithiasis”, to review diagnostic and therapeutic approaches for cholelithiasis in children from 2006 to 2016. Also, some articles were retrieved through hand searching and reviewing the reference lists of papers, regardless of the date of publication. Abstracts, duplicates, and articles irrelevant to childhood cholelithiasis were excluded.
A total of 36 out of 93 articles were reviewed. The results showed that the prevalence of childhood cholelithiasis varies in different communities, with a global rate of 1.9%. Most cases of cholelithiasis in children were associated with underlying diseases. Hemolytic diseases, hereditary blood disorders, and cirrhosis were among the main causes of cholelithiasis in children. Cholelithiasis was detected incidentally or via diagnostic evaluations due to the presentation of symptoms.
Although evaluation of the underlying causes of gallstone formation and appropriate diagnostic/therapeutic implications is still a challenging issue in the management of childhood cholelithiasis, in asymptomatic cases or those with gallstones of certain sizes, it is only recommended to monitor the disease or rule out the underlying causes. It should be noted that long periods of diagnostic and therapeutic approaches can impose stress and tension on families.