Cholelithiasis and biliary sludge in Downs syndrome patients

Although studies have demonstrated increased frequency of gallbladder abnormalities among Downs 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 evoluti...

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Published in:	São Paulo medical journal Vol. 125; no. 6; pp. 329 - 332
Main Authors:	Boëchat, Márcia Cristina Bastos, Silva, Kátia Silveira da, Llerena, Jr, Juan Clinton, Boëchat, Paulo Roberto Mafra
Format:	Journal Article
Language:	English
Published:	Brazil Associação Paulista de Medicina - APM 01-11-2007 Associação Paulista de Medicina
Subjects:	Age Distribution Bile - diagnostic imaging Bile Ducts - abnormalities Child, Preschool Cholecystectomy Cholecystitis Cholelithiasis - diagnostic imaging Cholelithiasis - epidemiology Cholelithiasis - etiology Cross-Sectional Studies Down syndrome Down Syndrome - complications Down Syndrome - physiopathology Female Gallbladder Gallbladder - diagnostic imaging Humans Infant Infant, Newborn Lithiasis Male MEDICINE, GENERAL & INTERNAL Original Prevalence Retrospective Studies Sex Distribution Ultrasonography Cholecystectomy Vesícula biliar Síndrome de Down Colecistectomia Colecistite Lithiasis Gallbladder Litíase Down syndrome Cholecystitis
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Summary:	Although studies have demonstrated increased frequency of gallbladder abnormalities among Downs 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 childrens hospital in Rio de Janeiro. This was a cross-sectional study followed by a retrospective cohort study on all individuals with an ultrasound diagnosis of gallbladder abnormalities. 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. 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. 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Conflict of interest: None
ISSN:	1516-3180 1806-9460 1516-3180 1806-9460
DOI:	10.1590/S1516-31802007000600005