腹腔镜胆囊切除术的2岁男性儿童胆石症和经常性的右季肋部疼痛--病例报告及文献复习

Laparoscopic cholecystectomy in a 2 year old male child with choleilithiasis and recurrent right hypochondrial pain- Case report and review of literature

Abstract
INTRODUCTION:
Gallstone disease has been considered an uncommon entity in children and infants, but its incidence is reportedly increasing which may be attributed to widespread use of diagnostic imaging (ultrasonography).

PRESENTATION OF CASE:
An apparently healthy 2 year old male child presented to our Outpatient department with chief complaint of recurrent abdominal pain. The episodes of pain were acute in onset and associated with vomiting. As per the complete examination and findings, a diagnosis of chronic calculous cholecystitis was made. A four port laparoscopic cholecystectomy was done.

DISCUSSION:
The incidence of gallstones in children in India has not been sufficiently studied. The incidence of gallstone disease in India was found to be 0.3% with the incidence in age group 0-10 being less than 0.1%. In contrast to adult gallstone disease, it has been found that there is no female preponderance in gallstone diseases of infancy. Also, the majority of children having increased haemoglobin turnover develop pigment stones only after 5 years of age.

CONCLUSION:
The probability of gallstone disease in infants and young children should not be ignored. Gall stones should always be considered as a differential diagnosis when young patients present with complaints of abdominal pain.

KEYWORDS:
Laparoscopic cholecystectomy; Pediatric cholelithiasis

腹腔镜胆囊切除术的2岁男性儿童胆石症和经常性的右季肋部疼痛--病例报告及文献复习

Fig. 1. Magnetic Resonance Cholangiopancreatography Image depicting multiple small calculi seen in gall bladder (red arrow). Common bile duct and common hepatic duct appear normal.

腹腔镜胆囊切除术的2岁男性儿童胆石症和经常性的右季肋部疼痛--病例报告及文献复习

腹腔镜胆囊切除术的2岁男性儿童胆石症和经常性的右季肋部疼痛--病例报告及文献复习

Fig. 2. (A) Intraoperative photograph showing a 5 mm supraumbilical camera portand a 5 mm epigastric port (long white arrow) with site of alligator port insertionin the midclavicular line and anterior axillary line marked by the smaller two whitearrows. (B) & (C) Depicting removal of gall bladder specimen and gross gall bladderspecimen respectively.

腹腔镜胆囊切除术的2岁男性儿童胆石症和经常性的右季肋部疼痛--病例报告及文献复习

Fig. 3. Showing: (A) Dissection of the Calot’s triangle. (B) Clipping of cystic duct. (C) Division of cystic duct. (D) Dissection of gall bladder off the gall bladder fossa.

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