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Sludge ball, pseudolithiasis, cholelithiasis and choledocholithiasis from intrauterine life to 2 years: a 13-year follow-up.
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Evaluation
and
follow-up
of
infants
with
cholelithiasis
and
pseudolithiasis
in
a
pediatric
ward
.
Prospective
study
from
April
1990
to
October
2003
identified
hospitalized
infants
younger
than
2
years
with
ultrasonographic
findings
of
cholelithiasis
,
choledocholithiasis
or
pseudolithiasis
.
Associated
abnormalities
or
contributory
factors
were
recorded
and
patients
were
followed
for
from
6
months
to
13
years
(
mean
,
4
years
)
.
Thirty
-
four
patients
were
diagnosed
between
the
age
of
3
weeks
and
24
months
.
Thirteen
(
38
%
)
had
been
treated
with
third
-generation
cephalosporins
.
Other
associated
factors
were
dehydration
in
10
(
29
%
)
,
urinary
tract
infection
in
two
(
6
%
)
and
one
each
for
cholestatic
liver
disease
,
total
parenteral
nutrition
,
immunoglobulin
A
deficiency
and
prematurity
.
Six
infants
(
17
%
)
had
no
known
risk
factor
.
Six
additional
patients
were
diagnosed
by
antenatal
ultrasound
.
Cholelithiasis
in
infants
hospitalized
for
a
variety
of
common
pediatric
conditions
is
not
rare
.
Dehydration
and
treatment
with
third
-generation
cephalosporins
are
important
associated
factors
.
The
classic
risk
factors
of
hemolysis
and
previous
gastrointestinal
surgery
,
were
not
found
in
our
group
.
The
overall
prognosis
was
good
.
Pseudolithiasis
disappeared
in
all
infants
.
Of
the
21
infants
with
cholelithiasis
,
only
two
developed
cholecystitis
.
In
nine
infants
,
spontaneous
resolution
occurred
.
In
the
absence
of
other
clinical
or
imaging
evidence
of
biliary
tract
disease
,
conservative
management
is
advised
.
