Cholelithiasis and biliary sludge in Down’s syndrome patients
CONTEXT AND OBJECTIVE: Although studies have demonstrated increased frequency of gallbladder abnormalities among Down’s syndrome (DS) patients in some countries, there is only one paper on this subject in the Brazilian literature. The aim of this study was to demonstrate the prevalence, clinical cha...
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| Format: | Article |
| Language: | English |
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Associação Paulista de Medicina
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| Series: | São Paulo Medical Journal |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802007000600005&lng=en&tlng=en |
| _version_ | 1818544687877718016 |
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| author | Márcia Cristina Bastos Boëchat Kátia Silveira da Silva Juan Clinton Llerena Jr Paulo Roberto Mafra Boëchat |
| author_facet | Márcia Cristina Bastos Boëchat Kátia Silveira da Silva Juan Clinton Llerena Jr Paulo Roberto Mafra Boëchat |
| author_sort | Márcia Cristina Bastos Boëchat |
| collection | DOAJ |
| description | CONTEXT AND OBJECTIVE: Although studies have demonstrated increased frequency of gallbladder abnormalities among Down’s syndrome (DS) patients in some countries, there is only one paper on this subject in the Brazilian literature. The aim of this study was to demonstrate the prevalence, clinical characteristics and evolution of lithiasis and biliary sludge among DS patients in a maternity and children’s hospital in Rio de Janeiro. DESIGN AND SETTING: This was a cross-sectional study followed by a retrospective cohort study on all individuals with an ultrasound diagnosis of gallbladder abnormalities. METHODS: 547 DS patients (53.2% male, 46.8% female) attending the Instituto Fernandes Figueira in 2001 underwent abdominal ultrasound examination at ages of between one day and three years (mean: five months). Clinical and ultrasound data were analyzed. RESULTS: In 50 patients (9.1%), the ultrasound demonstrated gallbladder abnormalities (6.9% lithiasis and 2.1% biliary sludge). Spontaneous resolution was observed in 66.7% of the patients with biliary sludge and 28.9% with lithiasis. Cholecystectomy was carried out on 26.3% of the patients with gallstones. CONCLUSION: The results from this study and comparison with the literature suggest that DS patients are at risk of developing lithiasis and biliary sludge and should be monitored throughout the neonatal period, even if there are no known risk factors for gallstone formation. Most frequently, these gallbladder abnormalities occur without symptoms and spontaneously resolve in most non-symptomatic patients. DS patients should be monitored with serial abdominal ultrasound, and cholecystectomy is indicated for symptomatic cases or when cholecystitis is present. |
| first_indexed | 2024-12-11T22:51:42Z |
| format | Article |
| id | doaj.art-5dfc6920aa5a4f0d8cf4bef73407bd08 |
| institution | Directory Open Access Journal |
| issn | 1806-9460 |
| language | English |
| last_indexed | 2024-12-11T22:51:42Z |
| publisher | Associação Paulista de Medicina |
| record_format | Article |
| series | São Paulo Medical Journal |
| spelling | doaj.art-5dfc6920aa5a4f0d8cf4bef73407bd082022-12-22T00:47:24ZengAssociação Paulista de MedicinaSão Paulo Medical Journal1806-9460125632933210.1590/S1516-31802007000600005S1516-31802007000600005Cholelithiasis and biliary sludge in Down’s syndrome patientsMárcia Cristina Bastos Boëchat0Kátia Silveira da Silva1Juan Clinton Llerena Jr2Paulo Roberto Mafra Boëchat3Fundação Oswaldo CruzFundação Oswaldo CruzFundação Oswaldo CruzFundação Oswaldo CruzCONTEXT AND OBJECTIVE: Although studies have demonstrated increased frequency of gallbladder abnormalities among Down’s syndrome (DS) patients in some countries, there is only one paper on this subject in the Brazilian literature. The aim of this study was to demonstrate the prevalence, clinical characteristics and evolution of lithiasis and biliary sludge among DS patients in a maternity and children’s hospital in Rio de Janeiro. DESIGN AND SETTING: This was a cross-sectional study followed by a retrospective cohort study on all individuals with an ultrasound diagnosis of gallbladder abnormalities. METHODS: 547 DS patients (53.2% male, 46.8% female) attending the Instituto Fernandes Figueira in 2001 underwent abdominal ultrasound examination at ages of between one day and three years (mean: five months). Clinical and ultrasound data were analyzed. RESULTS: In 50 patients (9.1%), the ultrasound demonstrated gallbladder abnormalities (6.9% lithiasis and 2.1% biliary sludge). Spontaneous resolution was observed in 66.7% of the patients with biliary sludge and 28.9% with lithiasis. Cholecystectomy was carried out on 26.3% of the patients with gallstones. CONCLUSION: The results from this study and comparison with the literature suggest that DS patients are at risk of developing lithiasis and biliary sludge and should be monitored throughout the neonatal period, even if there are no known risk factors for gallstone formation. Most frequently, these gallbladder abnormalities occur without symptoms and spontaneously resolve in most non-symptomatic patients. DS patients should be monitored with serial abdominal ultrasound, and cholecystectomy is indicated for symptomatic cases or when cholecystitis is present.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802007000600005&lng=en&tlng=enDown syndromeGallbladderLithiasisCholecystitisCholecystectomy |
| spellingShingle | Márcia Cristina Bastos Boëchat Kátia Silveira da Silva Juan Clinton Llerena Jr Paulo Roberto Mafra Boëchat Cholelithiasis and biliary sludge in Down’s syndrome patients São Paulo Medical Journal Down syndrome Gallbladder Lithiasis Cholecystitis Cholecystectomy |
| title | Cholelithiasis and biliary sludge in Down’s syndrome patients |
| title_full | Cholelithiasis and biliary sludge in Down’s syndrome patients |
| title_fullStr | Cholelithiasis and biliary sludge in Down’s syndrome patients |
| title_full_unstemmed | Cholelithiasis and biliary sludge in Down’s syndrome patients |
| title_short | Cholelithiasis and biliary sludge in Down’s syndrome patients |
| title_sort | cholelithiasis and biliary sludge in down s syndrome patients |
| topic | Down syndrome Gallbladder Lithiasis Cholecystitis Cholecystectomy |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802007000600005&lng=en&tlng=en |
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