Cholelithiasis in Infants: Risk Factors, Management, and the Role of Ursodeoxycholic Acid
Background: Cholelithiasis is a rare disease in infants, and there is limited data on its risk factors and management. Objectives: To evaluate the risk factors, management, and response to medical treatment of cholelithiasis in infants. Methods: Infants diagnosed with cholelithiasis by ultrasound be...
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MDPI AG
2024-12-01
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| author | Sevim Çakar Gülin Eren Cahit Barış Erdur Mehmet Önder Şafak Pelek Sedef Alpdoğan Duygu Demirtaş Çiğdem Ömür Ecevit Özlem Bekem |
| author_facet | Sevim Çakar Gülin Eren Cahit Barış Erdur Mehmet Önder Şafak Pelek Sedef Alpdoğan Duygu Demirtaş Çiğdem Ömür Ecevit Özlem Bekem |
| author_sort | Sevim Çakar |
| collection | DOAJ |
| description | Background: Cholelithiasis is a rare disease in infants, and there is limited data on its risk factors and management. Objectives: To evaluate the risk factors, management, and response to medical treatment of cholelithiasis in infants. Methods: Infants diagnosed with cholelithiasis by ultrasound between 2018 and 2023 were retrospectively analyzed. Details of patient history, imaging findings, current symptoms, and treatments were reviewed. Results: Over 5 years, 98 infants were diagnosed with cholelithiasis. Thirty-three (33.7%) were girls, and the most common risk factors were the use of cephalosporin antibiotic therapy in 46.9%, sepsis in 30.6%, total parenteral nutrition in 29.6%, prematurity in 27.6%, congenital heart disease in 18.4%, and genetic disease (Down syndrome diagnosis in seven patients) in 16.3%. Only fifteen patients (15.3%) were symptomatic. Ursodeoxycholic acid (UDCA) treatment was given to 90.8% of patients, but nine of them used it for a short period or irregularly, and regular users were 81.6%. Gallstones disappeared in 46 patients (46.9%), including 14 (30.4%) without using UDCA regularly. The response rate to UDCA treatment was lower in preterm infants (<i>p</i> = 0.004). Gallstone resolution was higher in the nonusers, 14/18 (77.8%) versus 32/79 (40.5%) (<i>p</i> = 0.03). Acute cholecystitis was observed in only four patients; no other complications were noted. No infant required surgical or endoscopic treatment. Conclusions: UDCA should not be used routinely in children, especially infants, except in symptomatic children with a contraindication to surgery or to reduce clinical symptoms. In the absence of symptoms, patients may be monitored clinically. |
| format | Article |
| id | doaj-art-6b922a9d21ed42819992f9660daf1dc9 |
| institution | Kabale University |
| issn | 2227-9067 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
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| series | Children |
| spelling | doaj-art-6b922a9d21ed42819992f9660daf1dc92024-12-27T14:18:03ZengMDPI AGChildren2227-90672024-12-011112155310.3390/children11121553Cholelithiasis in Infants: Risk Factors, Management, and the Role of Ursodeoxycholic AcidSevim Çakar0Gülin Eren1Cahit Barış Erdur2Mehmet Önder3Şafak Pelek4Sedef Alpdoğan5Duygu Demirtaş6Çiğdem Ömür Ecevit7Özlem Bekem8Department of Pediatrics, Division of Pediatric Gastroenterology, Faculty of Medicine, Dokuz Eylül University, Izmir 35330, TurkeyDepartment of Pediatrics, Division of Pediatric Gastroenterology, University of Health Sciences Dr. Behçet Uz Children’s Hospital, Izmir 35210, TurkeyDepartment of Pediatrics, Division of Pediatric Gastroenterology, University of Health Sciences Dr. Behçet Uz Children’s Hospital, Izmir 35210, TurkeyDepartment of Pediatrics, Division of Pediatric Gastroenterology, University of Health Sciences Dr. Behçet Uz Children’s Hospital, Izmir 35210, TurkeyDepartment of Pediatrics, Division of Pediatric Gastroenterology, University of Health Sciences Dr. Behçet Uz Children’s Hospital, Izmir 35210, TurkeyDepartment of Pediatrics, Faculty of Medicine, Ege University, Izmir 35040, TurkeyDepartment of Pediatrics, Division of Pediatric Gastroenterology, University of Health Sciences Dr. Behçet Uz Children’s Hospital, Izmir 35210, TurkeyDepartment of Pediatrics, Division of Pediatric Gastroenterology, University of Health Sciences Dr. Behçet Uz Children’s Hospital, Izmir 35210, TurkeyDepartment of Pediatrics, Division of Pediatric Gastroenterology, University of Health Sciences Dr. Behçet Uz Children’s Hospital, Izmir 35210, TurkeyBackground: Cholelithiasis is a rare disease in infants, and there is limited data on its risk factors and management. Objectives: To evaluate the risk factors, management, and response to medical treatment of cholelithiasis in infants. Methods: Infants diagnosed with cholelithiasis by ultrasound between 2018 and 2023 were retrospectively analyzed. Details of patient history, imaging findings, current symptoms, and treatments were reviewed. Results: Over 5 years, 98 infants were diagnosed with cholelithiasis. Thirty-three (33.7%) were girls, and the most common risk factors were the use of cephalosporin antibiotic therapy in 46.9%, sepsis in 30.6%, total parenteral nutrition in 29.6%, prematurity in 27.6%, congenital heart disease in 18.4%, and genetic disease (Down syndrome diagnosis in seven patients) in 16.3%. Only fifteen patients (15.3%) were symptomatic. Ursodeoxycholic acid (UDCA) treatment was given to 90.8% of patients, but nine of them used it for a short period or irregularly, and regular users were 81.6%. Gallstones disappeared in 46 patients (46.9%), including 14 (30.4%) without using UDCA regularly. The response rate to UDCA treatment was lower in preterm infants (<i>p</i> = 0.004). Gallstone resolution was higher in the nonusers, 14/18 (77.8%) versus 32/79 (40.5%) (<i>p</i> = 0.03). Acute cholecystitis was observed in only four patients; no other complications were noted. No infant required surgical or endoscopic treatment. Conclusions: UDCA should not be used routinely in children, especially infants, except in symptomatic children with a contraindication to surgery or to reduce clinical symptoms. In the absence of symptoms, patients may be monitored clinically.https://www.mdpi.com/2227-9067/11/12/1553childrengallstonesinfantursodeoxycholic acid |
| spellingShingle | Sevim Çakar Gülin Eren Cahit Barış Erdur Mehmet Önder Şafak Pelek Sedef Alpdoğan Duygu Demirtaş Çiğdem Ömür Ecevit Özlem Bekem Cholelithiasis in Infants: Risk Factors, Management, and the Role of Ursodeoxycholic Acid Children children gallstones infant ursodeoxycholic acid |
| title | Cholelithiasis in Infants: Risk Factors, Management, and the Role of Ursodeoxycholic Acid |
| title_full | Cholelithiasis in Infants: Risk Factors, Management, and the Role of Ursodeoxycholic Acid |
| title_fullStr | Cholelithiasis in Infants: Risk Factors, Management, and the Role of Ursodeoxycholic Acid |
| title_full_unstemmed | Cholelithiasis in Infants: Risk Factors, Management, and the Role of Ursodeoxycholic Acid |
| title_short | Cholelithiasis in Infants: Risk Factors, Management, and the Role of Ursodeoxycholic Acid |
| title_sort | cholelithiasis in infants risk factors management and the role of ursodeoxycholic acid |
| topic | children gallstones infant ursodeoxycholic acid |
| url | https://www.mdpi.com/2227-9067/11/12/1553 |
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