Infantile Cholelithiasis - Symptoms, Causes and Treatment

Introduction

The gallbladder stores bile (a liquid of cholesterol, bile pigments, salts, and water) between meals. Bile is released from the gallbladder into the intestines to aid food digestion when the child eats.

Infantile cholelithiasis is the term for gallstones that occur in infants. It is a rare condition but can cause complications if left untreated. Gallstones are hard deposits of bile and cholesterol in the gallbladder, a small organ located just under the liver. These stones can cause inflammation, pain, and blockages in the biliary system. In some cases, they can also lead to infection or pancreatitis. The most common cause of infantile cholelithiasis is a bile acid content or concentration imbalance. It occurs when the body produces too much bile or not enough bile to dissolve the cholesterol and other components of the bile.

How Does Gallstone Form?

Gallstones are hard deposits of cholesterol or other minerals in the gallbladder. The gallbladder is a small organ on the upper right side of the abdomen, just below the liver. Gallstones can range in size from a grain of sand to a golf ball and can be composed of cholesterol, bile salts, or calcium.

When the body digests fat, it produces a substance called bile. Bile is composed of cholesterol, bile salts, and other waste products. If the levels of cholesterol and bile salts become too high in the bile, they can crystallize and form stones.

What Are the Causes of Infantile Cholelithiasis?

The most common cause of infantile cholelithiasis is a bile acid content or concentration imbalance. It occurs when the body produces too much bile or not enough bile to dissolve the cholesterol and other components of the bile.

Infantile cholelithiasis can occur at any age but is most common in babies between the ages of one and two months old. While the exact cause is unknown, several factors may contribute to the development of the condition, including:

• Premature birth.

• Low birth weight.

• High levels of lipids in the blood.

• Inherited metabolic diseases.

• Congenital malformations of the gallbladder or biliary tract.

• Use of certain medications such as birth control pills.

• Excess weight gain during pregnancy or obesity.

• Blood diseases include sickle cell anemia, beta thalassemia, and hereditary spherocytosis.

• Conditions such as crohn’s disease and cerebral palsy.

• A history of requiring IV (intravenous) nutrition.

• A family history of gallstone.

• A history of abdominal surgery.

• Have cystic fibrosis.

What Problems Can Cholelithiasis Cause?

An Infant with gallstones may have the following:

• Biliary Colic - Pain from stones in the gallbladder.

• Cholecystitis - Infection of the gallbladder.

• Choledocholithiasis - Stones in the ducts draining the gallbladder that can obstruct the flow of bile.

• Pancreatitis - Inflammation of the pancreas.

What Are the Symptoms of Infentitle Cholelithiasis?

• Children with gallstones may experience pain in the upper right or middle of the abdomen. The pain may be more pronounced after meals, especially if the child has consumed fatty or greasy foods.

• Nausea and vomiting.

• Fever, chills, and sweats.

• Jaundice or when whites of eyes and skin turns yellow.

• Poor appetite.

• Dark urine.

• Clay-colored stools.

• Weight loss.

• A visible lump in the abdomen.

What Are the Tests to Diagnose Infantile Cholelithiasis?

The diagnosis of infantile cholelithiasis usually begins with a physical examination and a medical history. The doctor may order additional tests to confirm the diagnosis.

• Blood Test: A blood test can detect any signs of infection or inflammation in the bile ducts. Elevated liver enzymes may indicate the presence of gallstones.

• Ultrasound: An ultrasound is a non-invasive imaging test that uses sound waves to create pictures of the abdominal organs. It is used to detect the presence of gallstones in the gallbladder or bile ducts.

• CT Scan: A computed tomography (CT) scan is an X-ray procedure used to create detailed images of the gallbladder, liver, and other abdominal organs. It can help diagnose gallstones, identify blockages, and determine if surgery is needed.

• MRCP: Magnetic resonance cholangiopancreatography (MRCP) is an imaging procedure that uses magnetic fields and radio waves to produce images of the gallbladder and bile ducts. It can be used to detect gallstones, as well as any narrowing or blockage in the bile ducts.

• HIDA Scan: A hepatobiliary iminodiacetic acid (HIDA) scan is a nuclear medicine procedure used to evaluate the function of the gallbladder and bile ducts. It involves injecting a radioactive tracer into a vein, monitored as it moves through the digestive tract. This test can also detect gallstones and any blockages or narrowing in the bile ducts.

How Is Infantile Cholelithiasis Treated?

When treating infantile cholelithiasis, the main treatment options are medicine and surgery.

• Medicine: In mild or moderate symptoms, doctors may prescribe pain relievers and antispasmodics to help manage discomfort and reduce inflammation. Medication to dissolve the stones can also be used in certain cases.

• Surgery: Cholecystectomy (surgical removal of the gallbladder). In more severe cases, surgery may be necessary. During a cholecystectomy, the surgeon will make an incision near the gallbladder and remove gallstones and the gallbladder itself. This procedure can be done laparoscopically or open, depending on the size and complexity of the stones. The patient may need to take antibiotics to reduce the risk of infection and take time to recover.

How Can Cholelithiasis be Prevented?

Cholelithiasis can be prevented by making lifestyle changes, avoiding certain foods, and getting regular medical care.

1. Make Lifestyle Changes: Maintaining a healthy weight through diet and exercise is one of the most effective ways to reduce the risk of developing cholelithiasis. Eating a healthy diet and regular exercising can help maintain a healthy weight, reducing the risk of developing gallstones.

2. Avoid Certain Foods: Eating foods high in cholesterol or saturated fats can increase the risk of cholelithiasis. Therefore, it is important to limit these foods in the diet and avoid foods high in sugar or containing refined carbohydrates.

3. Get Regular Medical Care: If a person has an existing medical condition that could increase the risk for cholelithiasis, it is important to get regular medical care and follow up with the doctor regularly.

Conclusion

Infantile cholelithiasis is a condition in which infants have gallstones. This condition can cause significant discomfort and require medical attention. It is important to be aware of the symptoms and causes of infantile cholelithiasis so that it can be treated appropriately. Contact the doctor immediately for proper diagnosis and treatment if the child have this condition. With the right care, infants can quickly recover from cholelithiasis. Prevention requires lifestyle changes involving eating a balanced diet, drinking enough fluids, and exercising regularly. Following these practices can help reduce the risk of gallstones forming in infants.