Cholelithiasis and biliary sludge in Down’s syndrome patients

Authors

  • Márcia Cristina Bastos Boëchat Instituto Fernandes Figueira, Fundação Oswaldo Cruz
  • Kátia Silveira da Silva Instituto Fernandes Figueira, Fundação Oswaldo Cruz
  • Juan Clinton Llerena Júnior Instituto Fernandes Figueira, Fundação Oswaldo Cruz
  • Paulo Roberto Mafra Boëchat Instituto Fernandes Figueira, Fundação Oswaldo Cruz

Keywords:

Down syndrome, Gallbladder, Lithiasis, Cholecystitis, Cholecystectomy

Abstract

CONTEXT AND OBJECTIVE: Although studies have demonstrated increased frequency of gall- bladder 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 evolu- tion 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 ex- amination 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 pa- tients 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.

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Author Biographies

Márcia Cristina Bastos Boëchat, Instituto Fernandes Figueira, Fundação Oswaldo Cruz

MD. Pediatric radiologist, Radiology Service, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil.

Kátia Silveira da Silva, Instituto Fernandes Figueira, Fundação Oswaldo Cruz

PhD. Epidemiologist, Epidemiology Group, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil.

Juan Clinton Llerena Júnior, Instituto Fernandes Figueira, Fundação Oswaldo Cruz

PhD. Geneticist, Department of Medical Genetics, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil.

Paulo Roberto Mafra Boëchat, Instituto Fernandes Figueira, Fundação Oswaldo Cruz

MD. Pediatric surgeon, Department of Pediatric Surgery, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil.

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Published

2007-11-11

How to Cite

1.
Boëchat MCB, Silva KS da, Llerena Júnior JC, Boëchat PRM. Cholelithiasis and biliary sludge in Down’s syndrome patients . Sao Paulo Med J [Internet]. 2007 Nov. 11 [cited 2025 Mar. 18];125(6):329-32. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/2190

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Original Article